Nonurothelial Bladder Cancer and Rare Variant Histologies

Willis, Daniel; Kamat, Ashish M.

doi:10.1016/j.hoc.2014.10.011

Cited by 72 publications

(42 citation statements)

References 63 publications

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“…Most patients present with pure urothelial carcinoma of the bladder (UCB) histology, whereas variant UCB histology (i.e. the combination of UCB with other histologies) is seen in 10% to 25% of patients at radical cystectomy (RC) with bilateral pelvic lymphadenectomy , the ‘gold standard’ surgical treatment for muscle‐invasive and recurrent high‐risk non‐muscle‐invasive UCB refractory to intravesical therapies .…”

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confidence: 99%

Detection and oncological effect of circulating tumour cells in patients with variant urothelial carcinoma histology treated with radical cystectomy

et al. 2017

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Detection and oncological effect of circulating tumour cells in patients with variant urothelial carcinoma histology treated with radical cystectomy

et al. 2017

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“…However, in 10-25% of the cases, BC histology is different from the pure urothelial histology (PUH) and it is called "variant histology" (VH) referring to all pathologies in BC other than PUH. [7] Evidence from a retrospective analyses revealed that, patients with VH have more aggressive disease in comparison with PUH and poor response to existing therapies such as RC [7] . However, recent studies question this acceptance and noted that VHs might not be associated with decreased survival rates.…”

Section: Introductionmentioning

confidence: 99%

The association between variant urothelial histologies, pathological stage and disease specific survival in patients with bladder cancer

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Erdem

et al. 2018

Turkish Journal of Urology

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Objective: We aimed to compare the oncological outcomes of patients with variant urothelial histologies (VH) with pure urothelial histology (PUH) in bladder cancer (BC) patients. Material and methods:This study includes 223 patients who underwent radical cystectomies (RCs) between September 2006 and July 2016 with complete follow-up data A retrospective screening was performed to identify the patients with PUH and VH. The primary outcomes of interest were pathological stage of disease at RC and disease-specific survival (DSS). For comparison of categorical variables, Fisher's exact test and Pearson chi-square and for continuous variables Wilcoxon rank-sum and Mann-Whitney U tests were used. Kaplan-Meier (KM) method was used for survival analysis and log-rank test was used for comparison of survival rates. Predictors of survival were detected with mulitivariable Cox-proportional hazards model including the variables such as gender, age, existence of VH, lymph node dissection (LND) type and pathological stage of the disease. Results:A moderate-degree correlation was detected between VH and pathological stages of RC (r= 0.45, p<0.001). In PUH group, 39 (25.8%) of 151 patients died after a median follow-up of 20 (0-107) months; whereas 37 (51.4%) of 72 patients with VH died after a median follow-up of 16.5 (0-104) months (p<0.001). In terms of pathological stage, the number of patients with PUH and VH were at stages pT0-2 (n=100; 66.2% vs. n=19; 26.4%), pT3-4 (n=35; 23.2% vs. 38; 52.8%, and in 16 (10.6%) and 15 (20.8%) patients with LN positivity, respectively (p<0.001). KM survival analysis revealed a significantly decreased DSS in patients with VH compared to PUH (p<0.001). Meanwhile, pathological disease stage and existence of VH were found to be associated with decreased DSS in the multivariate model. Conclusion:The present study revealed that VH is associated with advanced pathological tumor stage at RC and decreased DSS compared to patients with PUH in patients with BC.

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“…However, the existence of tumor heterogeneity as well as the recognition of UC’s ability to differentiate (or de-differentiate) into different phenotypes have led to characterization of several variants of UC (VUC) (4). Squamous, glandular, micropapillary and sarcomatoid differentiation are the most frequently observed (4). Identification of variant histology has been challenging as no common definition has been used among studies, and the term refers to any bladder cancer with features other than pure UC (PUC), often including mixed forms (4).…”

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confidence: 99%

“…Squamous, glandular, micropapillary and sarcomatoid differentiation are the most frequently observed (4). Identification of variant histology has been challenging as no common definition has been used among studies, and the term refers to any bladder cancer with features other than pure UC (PUC), often including mixed forms (4). This is further complicated by the frequent lack of recognition of variant histology, particularly among community pathologists, and also the lack of concordance between TUR and RC specimens, with a sensitivity of TUR in detecting VUC as low as 39% (5).…”

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