Urothelial Carcinoma Versus Squamous Cell Carcinoma of Bladder: Is Survival Different With Stage Adjustment?

Scosyrev, Emil; Yao, Jorge L.; Messing, Edward M.

doi:10.1016/j.urology.2008.11.042

Cited by 98 publications

(73 citation statements)

References 16 publications

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“…11 Consistent with previous comparative studies with conventional urothelial carcinoma, our patients with SCC of the bladder experienced worse CSS and OS. 8 SqD and SCC may share similar genetic alterations and molecular pathways of dedifferentiation, which may explain why our results suggest comparable outcomes. [3][4][5] We found that patients with positive lymph nodes and SqD fared worse than those with positive lymph nodes and SCC.…”

Section: Discussionmentioning

confidence: 67%

“…6,7 Similarly, compared to conventional urothelial carcinoma, SCC has been associated with adverse oncologic outcomes after adjusting for the effects of stage and common prognostic factors. 8 To our knowledge no study has compared the clinical outcomes of patients with SCC to the outcomes of those with SqD. We compared the cancer specific survival and overall survival of patients with SCC and SqD, and identified prognostic factors in those treated with radical cystectomy for each histological variant.…”

Section: Introductionmentioning

confidence: 99%

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1593 Comparative Outcomes of Pure Squamous Cell Carcinoma and Urothelial Carcinoma With Squamous Differentiation in Patients Treated With Radical Cystectomy

et al. 2011

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Purpose-We compared clinical outcomes, and identified predictors of cancer specific and overall survival after radical cystectomy in patients with urothelial carcinoma with squamous differentiation and those with pure squamous cell carcinoma.Materials and Methods-We reviewed data on 2,031 patients treated with radical cystectomy and pelvic lymph node dissection at a single high volume referral center. Of these patients 78 had squamous cell carcinoma and 67 had squamous differentiation. Survival estimates by histological subtype were described using Kaplan-Meier methods. Within histological subtypes pathological stage, nodal invasion, soft tissue margins, age and gender were evaluated as predictors of cancer specific survival and overall survival using univariate Cox regression.Results-Median followup was 44 months. Of 104 patient deaths 60 died of their disease. We did not find a statistically significant difference between survival curves of patients with squamous cell carcinoma and squamous differentiation (log rank overall survival p = 0.6, cancer specific survival p = 0.17). Positive soft tissue margins were associated with worse cancer specific survival (HR 6.92, p ≤ 0.0005) and overall survival (HR 3.68, p ≤ 0.0005) in patients with pure squamous cell carcinoma. Among patients with squamous differentiation, pelvic lymphadenopathy was associated with decreased overall survival (HR 2.52, 95% CI 1.33-4.77, p = 0.004) and cancer specific survival (HR 3.23, 95% CI 1.57-6.67, p = 0.002).Conclusions-There appears to be no evidence of a difference in cancer specific survival or overall survival between patients with squamous cell carcinoma and those with squamous differentiation treated with radical cystectomy and pelvic lymph node dissection. Patients with squamous differentiation and tumor metastases to pelvic lymph nodes should be followed more closely, and adjuvant treatment should be considered to improve survival. Wide surgical resection is critical to achieve local tumor control and improve survival in patients with squamous cell carcinoma. Urothelial carcinoma with SqD occurs along a similar molecular pathway, and is histologically characterized by intercellular bridges and keratinization. [3][4][5] Compared to conventional urothelial carcinoma, SqD is an adverse pathological feature associated with worse recurrence-free and cancer specific survival. 6,7 Similarly, compared to conventional urothelial carcinoma, SCC has been associated with adverse oncologic outcomes after adjusting for the effects of stage and common prognostic factors. 8To our knowledge no study has compared the clinical outcomes of patients with SCC to the outcomes of those with SqD. We compared the cancer specific survival and overall survival of patients with SCC and SqD, and identified prognostic factors in those treated with radical cystectomy for each histological variant. MATERIALS AND METHODS Patient PopulationBetween February 1990 and July 2009, 2,031 patients were treated with RCPLND at our institution. Of these cases...

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Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

1593 Comparative Outcomes of Pure Squamous Cell Carcinoma and Urothelial Carcinoma With Squamous Differentiation in Patients Treated With Radical Cystectomy

et al. 2011

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“…Tümör derinliği arttıkça lenf nodu pozitifliği de artmaktadır. [27,28] Lenfadenektominin genişliği ve çıkarılan lenf nodu sayısı sistektomi uygulanan hastalarda prognostik bir öneme sahiptir. Hong ve ark., [29] daha çok lenf nodu çıkarıldığında, lenf nodu tutulumu pozitif ve negatif olan hastalarda sistektomi sonrası sağkalımın olumlu yönde etkilendiğini rapor etmiştir.…”

Section: Discussionunclassified

The effect of gender on oncological outcomes in patients who have undergone radical cystectomy due to bladder cancer

Şefik¹,

Görgel²,

Balcı³

et al. 2012

Turkish Journal of Urology

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Objective: The aim of this study was to evaluate the effect of gender on oncologic results in patients who have undergone radical cystectomy due to bladder cancer. Materials and methods:We retrospectively reviewed data from 460 patients who had radical cystectomy due to bladder cancer in our clinic. A total of 420 of the patients were men, and 40 patients were women. We evaluated the tumor type, tumor stage, tumor grade, lymph node involvement status, complications and survival rates of the females. These parameters were compared to male cystectomy data. Results:The median age of male and female patients was 60.59±8.966 and 63.2±7.816, respectively (p= 0.076). In total, 79.4% of the males and 70.3% of females had transitional cell cancer (p= 0.192). The detection frequencies for pT1, pT2, pT3 vs. pT4 stage tumors in males and females was 18%, 34.2%, 33.4% vs. 14% and 2.8%, 33.3%, 41.7%, 22.2%, respectively. The percentage of the lymph node involvement in female and male patients was 48.5% and 23.9% (p= 0.02). The grade 3 tumor involvement in female and male patients was 80.6% and 72.7% (p= 0.621). In females, the bladder-confined tumor percentage was 22.2% and males rate was 48.3% (p= 0.04). In terms of overall complications, no significant differences were found between males and females. Disease-specific survival (DSS) was 115±42.2 months in males and 18±2.14 months in females. Three-year DSS was 61.4% in males and 15.3% in females (p= 0.013). Median overall survival was 47±11.789 months in males and 18±1.581 months in females. Three-year overall survival was 53.2% for males and 11.4% for females. A significant difference was found between males and females (p= 0.013). Conclusion:In this study, we found that females present worse disease specific and overall survival rates than males due to poor prognostic factors such as lymph node involvement and the higher prevalence of extravesical disease in female patients.Key words: Bladder cancer; gender; radical cystectomy. ÖZETAmaç: Bu çalışmanın amacı mesane tümörü nedeniyle radikal sistektomi yapılan hastalarda cinsiyetin onkolojik sonuçlara etkisini değerlendirmektir. Gereç ve yöntem:Kliniğimizde mesane tümörü nedeniyle radikal sistektomi uygulanan 460 hastanın verileri retrospektif olarak incelendi. 420 erkek ve 40 kadın hasta çalışmaya dahil edildi. Kadın sistektomi olgularının tümör tipi, tümör evreleri, tümör derecesi, lenf nodu tutulum oranları, komplikasyonlar ve sağ kalım verileri değerlendirildi. Bu parametreler açısından erkek sistektomi olgularıyla karşılaştırıldı. Bulgular: Erkek hastaların yaş ortalaması 60.59±8.966, kadın hastaların yaş ortalaması ise 63.2±7.816 idi (p= 0.076). Erkek hastaların %79.4'ü transizyonel hücreli kanser iken kadın hastalarda bu oran %70.3 idi (p= 0.192). Kadın hastalarda pT1, pT2, pT3 ve pT4 evrelerinde tümör saptanma sıklığı sırasıyla %2.8, %33.3, %41.7, %22.2 iken erkeklerde bu oranlar sırasıyla %18, %34.2, %33.4 ve %14 idi. Lenf nodu tutulumu açı-sından olgular değerlendirildiğinde kadın hastalarda lenf notu tutul...

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“…Another recent study using a similar SEER database demonstrated that SCC was more aggressive than Urothelial cancer after adjusting for common prognostic factors, such as stage and grade (Scosyrev et al, 2009). Scosyrev et al (2009) concluded that SCC was an independent predictor of mortality among patients with stage III and IV disease, and among patients with stage I and II disease who did not undergo cystectomy as part of their treatment. Therefore, squamous histology was not associated with increased mortality among patients with stage I and II disease when treated with cystectomy.…”

Section: Radical Cystectomymentioning

confidence: 99%

“…Muscle-invasive SCC patients showed worse survival regardless of stage. In SA-BC, Ghoneim et al (2008) (Ghoneim et al, 2008,Scosyrev et al, 2009,Ploeg et al, 2010& Zaghloul, 2010.…”

Section: Radical Cystectomymentioning

confidence: 99%

Bladder Cancer and Schistosomiasis: Is There a Difference for the Association?

Zaghloul¹,

Gouda²

2012

Bladder Cancer - From Basic Science to Robotic Surgery

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Urothelial Carcinoma Versus Squamous Cell Carcinoma of Bladder: Is Survival Different With Stage Adjustment?

Cited by 98 publications

References 16 publications

1593 Comparative Outcomes of Pure Squamous Cell Carcinoma and Urothelial Carcinoma With Squamous Differentiation in Patients Treated With Radical Cystectomy

1593 Comparative Outcomes of Pure Squamous Cell Carcinoma and Urothelial Carcinoma With Squamous Differentiation in Patients Treated With Radical Cystectomy

The effect of gender on oncological outcomes in patients who have undergone radical cystectomy due to bladder cancer

Bladder Cancer and Schistosomiasis: Is There a Difference for the Association?

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