Palliative chemotherapy for non-transitional cell carcinomas of the urothelial tract

Abstract

Non-transitional cell carcinomas of the urothelial tract comprise 5-10% of urothelial cancers. Clinical information regarding the clinical behavior and chemotherapy outcome of non-transitional cell carcinomas of the urothelial tract are incomplete due to their rarity. The object of this study was to evaluate the clinical features and the efficacy of palliative chemotherapy in advanced non-transitional cell carcinomas of the urothelial tract. We analyzed the clinical records of 21 consecutive patients who received palliative chemotherapy for unresectable or metastatic non-transitional cell carcinomas of the urothelial tract between January 1995 and November 2007. All the 21 patients received first-line chemotherapy with platinum-based regimens which are known to be effective in transitional cell urothelial carcinomas. The median age of the patients was 57 years (range, 27-71 years). The primary sites of involvement were the bladder, urethra, urachus, and ureter in 43%, 29%, 19%, and 10% of the patients, respectively. Adenocarcinoma was the most common histological type (67%); squamous cell carcinoma and small cell carcinoma comprised 24 and 10% of the histologic types, respectively. With a median duration of follow-up of 32 months (range, 12-71 months), the median overall survival for all 21 patients from the day of first-line chemotherapy was 13 months (95% CI, 6.8-19.2). The expected 1-year survival rate was 50.6% (95% CI, 28.6-72.5). Univariate analysis showed a better median overall survival in patients with adenocarcinoma, compared to non-adenocarcinomas (47 vs. 10 months, P = 0.049). The median overall survival of patients who received platinum-based palliative chemotherapy for advanced non-transitional cell carcinomas was comparable to previous studies for patients with transitional cell carcinomas. Adenocarcinomas appear to have a favorable prognosis for the survival of the patients who received platinum-based chemotherapy for advanced non-transitional cell carcinomas.

Non-Urothelial Bladder Cancer: Comparison of Clinicopathological and Prognostic Characteristics in Pure Adenocarcinoma and Non-Bilharzial Squamous Cell Carcinoma of the Bladder

“…Our multivariate analysis showed that factors affecting OS were advanced age, stage IV disease, and poor ECOG performance status. In our study, the median survival times of patients with SqCC and those with AC receiving platinum-based treatment during the metastatic period were 7.7 and 30.3 months, respectively, in accordance with the literature [27]. The ORR was 33% for AC and SqCC, and the stable disease rates were 33% and 0.0% for AC and SqCC, respectively.…”

Neoadjuvant chemotherapy prior to radical cystectomy for muscle‐invasive bladder cancer with variant histology

“…However, differences in prognosis are not as apparent when adjusted for disease stage. In addition, it has been shown that nonpure urothelial histological variants demonstrate a different response to systemic therapies in a palliative setting compared with those with pure urothelial histology . Nevertheless, this cannot be translated into generalized recommendations regarding perioperative chemotherapy for patients with localized muscle‐invasive bladder cancer.…”

Urothelial Carcinoma with Squamous Differentiation is Associated with High Tumor Stage and Pelvic Lymph-Node Metastasis

“…[3][4][5][6][7][8][9][10] Although urothelial carcinoma with squamous differentiation may be associated with poor prognosis, conflicting data have been reported regarding the role of squamous differentiation in unfavorable clinical outcomes. 7,[10][11][12][13][14][15][16] Because it is not uncommon for squamous differentiation to concurrently occur with other histological variants of urothelial carcinoma, such as micropapillary, glandular, and sarcomatoid differentiation, studies that report on mixed urothelial carcinoma variants may contribute to the discrepancies. 10,17,18 In this study, our aim was to compare tumor pathological stage and status of pelvic lymph-node metastasis between invasive urothelial carcinoma and urothelial carcinoma with squamous differentiation in patients who underwent cystectomy.…”