Micropapillary Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-analysis of Disease Characteristics and Treatment Outcomes

Abufaraj, Mohammad; Foerster, Beat; Schernhammer, Eva; Moschini, Marco; Kimura, Shoji; Hassler, Melanie R.; Preston, Mark A.; Karakiewicz, Pierre I.; Remzi, Mesut; Shariat, Shahrokh F.

doi:10.1016/j.eururo.2018.11.052

Cited by 95 publications

(60 citation statements)

References 37 publications

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“…Results from various studies are summarized in a recent meta-analysis that investigated the effects of NAC in presence of micropapillary variant. Authors reported pathological complete response ranging from 11% to 55% without significantly affecting RFS (HR 1.23, 95% CI 0.52-2.93, p = 0.6), CSS (HR 0.9, 95% CI 0.48-1.7, p = 0.8), or OS (HR 1.35, 95% CI 0.98-1.86, p = 0.1) [19].…”

Section: Pathological Classificationmentioning

confidence: 99%

Predicting Response to Neoadjuvant Chemotherapy in Bladder Cancer

Motterle

Andrews

Morlacco

et al. 2020

European Urology Focus

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Section: Pathological Classificationmentioning

confidence: 99%

Predicting Response to Neoadjuvant Chemotherapy in Bladder Cancer

Motterle

Andrews

Morlacco

et al. 2020

European Urology Focus

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“…Micropapillary bladder cancer is one of the more common variant histologies with a particular aggressive phenotype for which BCG is probably less effective. While some authors advocate proactive immediate radical cystectomy in patients with T1 disease with micropapillary variant component, others argue that bladder-conserving strategy such as BCG therapy can be beneficial, with immediate radical cystectomy not being superior to conservative measures [32].…”

Section: Discussion Of Treatment Optionsmentioning

confidence: 99%

How to Treat a Patient with T1 High-grade Disease and No Tumour on Repeat Transurethral Resection of the Bladder?

Shariat

Catto

2021

European Urology Oncology

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This case presents a 64-yr-old, healthy man who noted microscopic haematuria and immediately sought an appointment with the physician. He was a long-term heavy smoker, which alerts the physician to bladder cancer. The standard practice in Austria includes an ultrasound scan, which revealed a small lesion in the bladder of this patient. Cytology is suspicious for high-grade cancer, and transurethral resection of the bladder (TURB) reveals a single primary unifocal 2.0-cm tumour on the left side. During TURB with blue light using hexaminolevulinate (Hexvix), there were two foci of concomitant carcinoma in situ (CIS). The pathology revealed PT1 high grade without lymphovascular invasion or variant histology, with two foci of CIS, that is, a pure urothelial T1 2.0-cm unifocal nonmuscle-invasive bladder cancer (NMIBC) lesion. At this point, the physician opted for a repeat TURB (re-TURB). This revealed no residual tumour, and the computed tomography (CT) urogram was normal as well. The question is: What is the best treatment for this patient? 2. Option A: the case for conservative therapy Why should we choose conservative intravesical treatment in this patient-a healthy 64-yr-old man with T1 grade 3

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“…Urachal adenocarcinoma is covered in a separate review by the CUA and GUMOC [197]. Supporting evidence for OS benefit of NAC is limited or has conflicting results in micropapillary [198][199][200][201][202], plasmacytoid [203][204][205][206][207][208], nested [209,210], and sarcomatoid variants [177,[211][212][213], thus recommendations cannot be made in these settings at this time. Local definitive therapy may be the most important component of curative therapy.…”

Section: Variant Histologymentioning

confidence: 99%

Current Management of Localized Muscle-Invasive Bladder Cancer: A Consensus Guideline from the Genitourinary Medical Oncologists of Canada

Jiang

North

Canil

et al. 2020

BLC

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BACKGROUND: Despite recent advances in the management of muscle-invasive bladder cancer (MIBC), treatment outcomes remain suboptimal, and variability exists across current practice patterns. OBJECTIVE: To promote standardization of care for MIBC in Canada by developing a consensus guidelines using a multidisciplinary, evidence-based, patient-centered approach who specialize in bladder cancer. METHODS: A comprehensive literature search of PubMed, Medline, and Embase was performed; and most recent guidelines from national and international organizations were reviewed. Recommendations were made based on best available evidence, and strength of recommendations were graded based on quality of the evidence. RESULTS: Overall, 17 recommendations were made covering a broad range of topics including pathology review, staging investigations, systemic therapy, local definitive therapy and surveillance. Of these, 10 (59% ) were level 1 or 2, 7 (41% ) were level 3 or 4 recommendations. There were 2 recommendations which did not reach full consensus, and were based on majority opinion. This guideline also provides guidance for the management of cisplatin-ineligible patients, variant histologies, and bladder-sparing trimodality therapy. Potential biomarkers, ongoing clinical trials, and future directions are highlighted. CONCLUSIONS: This guideline embodies the collaborative expertise from all disciplines involved, and provides guidance to further optimize and standardize the management of MIBC.

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Micropapillary Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-analysis of Disease Characteristics and Treatment Outcomes

Cited by 95 publications

References 37 publications

Predicting Response to Neoadjuvant Chemotherapy in Bladder Cancer

Predicting Response to Neoadjuvant Chemotherapy in Bladder Cancer

How to Treat a Patient with T1 High-grade Disease and No Tumour on Repeat Transurethral Resection of the Bladder?

Current Management of Localized Muscle-Invasive Bladder Cancer: A Consensus Guideline from the Genitourinary Medical Oncologists of Canada

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