Claps, Francesco and van de Kamp, Maaike W. and Mayr, Roman and Bostrom, Peter J. and Shariat, Shahrokh F. and Hippe, Katrin and Bertz, Simone and Neuzillet, Yann and Sanders, Joyce and Otto, Wolfgang and van Der Heijden, Michiel S. and Jewett, Michael A. S. and Stoehr, Robert and Zlotta, Alexandre R. and Trombetta, Carlo and Eckstein, Markus and Mertens, Laura S. and Burger, Maximilian and Soorojebally, Yanish and Wullich, Bernd and Bartoletti, Riccardo and Radvanyi, Francois and Pavan, Nicola and Sirab, Nanour and Mir, M. Carmen and Pouessel, Damien and van Der Kwast, Theo H. and Hartmann, Arndt and Lotan, Yair and Bussani, Rossana and Allory, Yves and van Rhijn, Bas W. G. (2023) Prognostic impact of variant histologies in urothelial bladder cancer treated with radical cystectomy. BJU INTERNATIONAL, 132 (2). pp. 170-180. ISSN 1464-4096, 1464-410X
Full text not available from this repository. (Request a copy)Abstract
ObjectivesTo evaluate variant histologies (VHs) for disease-specific survival (DSS) in patients with invasive urothelial bladder cancer (BCa) undergoing radical cystectomy (RC). Materials and MethodsWe analysed a multi-institutional cohort of 1082 patients treated with upfront RC for cT1-4aN0M0 urothelial BCa at eight centres. Univariable and multivariable Cox' regression analyses were used to assess the effect of different VHs on DSS in overall cohort and three stage-based analyses. The stages were defined as 'organ-confined' (<= pT2N0), 'locally advanced' (pT3-4N0) and 'node-positive' (pTanyN1-3). ResultsOverall, 784 patients (72.5%) had pure urothelial carcinoma (UC), while the remaining 298 (27.5%) harboured a VH. Squamous differentiation was the most common VH, observed in 166 patients (15.3%), followed by micropapillary (40 patients [3.7%]), sarcomatoid (29 patients [2.7%]), glandular (18 patients [1.7%]), lymphoepithelioma-like (14 patients [1.3%]), small-cell (13 patients [1.2%]), clear-cell (eight patients [0.7%]), nested (seven patients [0.6%]) and plasmacytoid VH (three patients [0.3%]). The median follow-up was 2.3 years. Overall, 534 (49.4%) disease-related deaths occurred. In uni- and multivariable analyses, plasmacytoid and small-cell VHs were associated with worse DSS in the overall cohort (both P = 0.04). In univariable analyses, sarcomatoid VH was significantly associated with worse DSS, while lymphoepithelioma-like VH had favourable DSS compared to pure UC. Clear-cell (P = 0.015) and small-cell (P = 0.011) VH were associated with worse DSS in the organ-confined and node-positive cohorts, respectively. ConclusionsMore than 25% of patients harboured a VH at time of RC. Compared to pure UC, clear-cell, plasmacytoid, small-cell and sarcomatoid VHs were associated with worse DSS, while lymphoepithelioma-like VH was characterized by a DSS benefit. Accurate pathological diagnosis of VHs may ensure tailored counselling to identify patients who require more intensive management.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | OUTCOMES; CARCINOMA; METAANALYSIS; bladder urothelial carcinoma; radical cystectomy; variant histology; survival; prognosis; #BladderCancer; #blcsm; #utuc; #uroonc |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Mar 2024 09:50 |
| Last Modified: | 23 Mar 2024 09:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60420 |
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