Effect of variant histology presence and squamous differentiation on oncological results and patient’s survival after radical cystectomy

Şefik, Ertuğrul; Çelik, Serdar; Basmacı, İsmail; Yarımoğlu, Serkan; Bozkurt, İbrahim Halil; Yonguç, Tarık; Günlüsoy, Bülent

doi:10.4081/aiua.2018.3.172

Cited by 9 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The same was not true for comparisons between mixed variant histology with conventional UC. It is worth noting that some studies that reported no significant difference in survival outcomes between conventional UC and VH of UC had predominantly squamous and/glandular differentiation such as was reported in Sefik et al (32). Hajiran et al (14) was the only study to compare the survival benefit of NAC between the three groups of conventional UC, UC with VH and UC with variant differentiation (squamous or glandular); here survival benefit with NAC was only achieved in conventional UC and UC with VH.…”

Section: Glandular Differentiationmentioning

confidence: 82%

Overview of histologic variants of urothelial carcinoma: current trends and narrative review on treatment outcomes

Ogbue

Haddad²,

Almassi³

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

Background and Objective: The histologic variants of urothelial carcinoma (UC) are tumors arising from within the urothelium in which some component of the tumor morphology is other than urothelial.They are underdiagnosed, aggressive and have varying pathologic response rates to systemic chemotherapy.There are no consensus guidelines on the use of systemic chemotherapy in variant histology (VH) of UC. We performed a contemporary review on pathologic response rates to neoadjuvant systemic therapy and survival outcomes following radical cystectomy in order to provide a rationale for clinical practice recommendations on the management of UC with VH.Methods: A PubMed literature search was conducted for all English articles from inception reporting either pathological response rates to neoadjuvant treatment or survival outcomes after radical cystectomy in non-metastatic VH of UC.Key Content and Findings: Neoadjuvant chemotherapy (NAC) prior to radical cystectomy was shown to be a beneficial treatment strategy in UC with VH. The micropapillary, plasmacytoid, nested and sarcomatoid histologic variants were associated with worse survival outcomes compared to conventional UC and UC with squamous or glandular differentiation despite initial downstaging with chemotherapy. There is evidence of improved survival in patients with sarcomatoid differentiation receiving NAC compared to RC alone. The major prognostic factors that affect survival outcomes in VH of UC include histologic variant subtype, patient age, presence of lymphovascular invasion, hydronephrosis, nodal metastasis and advanced T stage at diagnosis. Recent studies demonstrate that VH of UC are heterogenous tumors and responsiveness to NAC may be a function of the molecular subtypes present.Conclusions: Based on these findings, NAC to achieve pathologic downstaging prior to radical cystectomy is recommended for MIBC with VH. Biomarkers identified by molecular profiling with immunohistochemistry will need to be validated as predictors of response to NAC in future trials.

show abstract

Section: Glandular Differentiationmentioning

confidence: 82%

Overview of histologic variants of urothelial carcinoma: current trends and narrative review on treatment outcomes

Ogbue

Haddad²,

Almassi³

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…Recent studies show that patients with squamous or glandular urothelial tumors have survival rates comparable to those with pure urothelial tumor (3,5). In a study by Sefik et al patients with variant histology were observed to have proportionally higher T stage compared to nonvariant urothelial carcinoma; however there were no significant differences for overall survival and cancer-specific survival (6). A recent study by Pereira et al evidenced that although bladder cancers with histological variants are clearly associated with features of more aggressive behavior, they had not any significant impact in survival expectancies (7).…”

Section: Original Papermentioning

confidence: 97%

Radical cystectomy for bladder urothelial carcinoma with aggressive variant histology

Mehrnoush

Brennan

Ismail

et al. 2022

Arch Ital Urol Androl

View full text Add to dashboard Cite

Purpose: The aim of this study is to report our experience in managing bladder cancer in patients with variant pathology. Methods: Retrospective data collection for all patients managed by radical cystectomy over the last 3 years for a variant pathol-ogy was completed. We speciﬁcally included micropapillary and nested variants. Results: Ten patients were identiﬁed, with eight having micropapillary carcinoma (MPC) and two having nested vari-ants. Nine patients were male. The median age was 75. The two patients with nested variant were 56 and 62 years old, respec-tively, whereas all patients with MPC were over the age of 70. Upon cystectomy of all micropapillary cases, three patients(37.5%) had positive lymph node invasion and the ﬁnal patholo-gy was T2 (two patients), T3 (two patients), and T4 (four patients). Barring a grade III complication Clavien-Dindo classi-ﬁcation due to wound dehiscence that necessitated secondary surgical closure, there were no speciﬁc perioperative complica-tions. Given the urethral invasion, cystourethrectomy was per-formed on the female patient. Within a median 13-month fol-low-up, three patients developed local recurrence, including two urethral and one new lateral pelvic mass. Conclusions: Considering the muscle invasive nature of micropapillary and nested bladder cancer, aggressive surgical management should not be postponed. Moreover, due to notable prevalence of concurrent and/or recurrent urethral involvement, initial urethrectomy or early and frequent postoperative ure-throscopy should be provided. Patients with variant histology bladder cancer may beneﬁt from early radical cystectomy when compared to bladder sparing protocols and prostate sparing cystectomy treatment options.

show abstract

“…A large number of studies have clari ed that squamous differentiation is an important prognostic factor of urothelial carcinoma [9][10][11][12][13], but there is no relevant research on squamous differentiation in patients with pT1 LGBC. Our study intends to clarify the role of squamous differentiation in pT1 LGBC, and to our knowledge, this is the rst study focusing on the clinical signi cance of squamous differentiation in pT1…”

Section: Introductionmentioning

confidence: 99%

Squamous Differentiation in pT1 Low-Grade Bladder Urothelial Carcinoma is Associated with High Risk of Recurrence

Wei

Zhang

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

Background A large number of studies have confirmed that squamous differentiation is closely related to the prognosis of bladder cancer, and studies also showed that it is an independent predictor for the prognosis of such disease. However, the role of squamous differentiation in pT1 low-grade bladder cancer (LGBC) has not been reported yet. This study mainly intends to explore the clinical significance of squamous differentiation in pT1 LGBC.Methods The clinicopathological data of 582 patients with pT1 LGBC from April 2007 to December 2018 were retrospectively analyzed, including 51 cases pathologically diagnosed as pT1 LGBC with squamous differentiation, and 531 cases as pT1 LGBC without squamous differentiation. The clinicopathological characteristics and prognosis of patients in the two groups were compared.Results 51 cases (8.7%) were pathologically diagnosed as pT1 LGBC with squamous differentiation. As compared with non-squamous differentiation, squamous differentiation was closely related to the age of patients (P=0.009) and postoperative recurrence (P<0.001). Further studies on the pT1 LGBC recurrence group showed that the patients in the squamous differentiation group were more prone to multiple recurrences (P=0.033) and invasive recurrence (P<0.001) after surgery. The Kaplan-Meier analysis indicated that pT1 LGBC patients with squamous differentiation had shorter recurrence-free survival (RFS) time. The Cox proportional hazard analysis confirmed that squamous differentiation was an independent predictor of RFS time in patients with pT1 LGBC.Conclusions Squamous differentiation is closely related to postoperative recurrence of pT1 LGBC, especially multiple recurrences and invasive recurrence after surgery. Squamous differentiation is an independent predictor of the RFS time in patients with pT1 LGBC.

show abstract

Effect of variant histology presence and squamous differentiation on oncological results and patient’s survival after radical cystectomy

Cited by 9 publications

References 7 publications

Overview of histologic variants of urothelial carcinoma: current trends and narrative review on treatment outcomes

Overview of histologic variants of urothelial carcinoma: current trends and narrative review on treatment outcomes

Radical cystectomy for bladder urothelial carcinoma with aggressive variant histology

Squamous Differentiation in pT1 Low-Grade Bladder Urothelial Carcinoma is Associated with High Risk of Recurrence

Contact Info

Product

Resources

About