The Impact of Squamous and Glandular Differentiation on Survival After Radical Cystectomy for Urothelial Carcinoma

No AccessJournal of UrologyAdult Urology1 Aug 2012The Impact of Squamous and Glandular Differentiation on Survival After Radical Cystectomy for Urothelial Carcinoma Simon P. Kim, Igor Frank, John C. Cheville, R. Houston Thompson, Christopher J. Weight, Prabin Thapa, and Stephen A. Boorjian Simon P. KimSimon P. Kim Department of Urology, Mayo Clinic, Rochester, Minnesota , Igor FrankIgor Frank Department of Urology, Mayo Clinic, Rochester, Minnesota , John C. ChevilleJohn C. Cheville Department of Pathology, Mayo Clinic, Rochester, Minnesota , R. Houston ThompsonR. Houston Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota , Christopher J. WeightChristopher J. Weight Department of Urology, Mayo Clinic, Rochester, Minnesota , Prabin ThapaPrabin Thapa Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota , and Stephen A. BoorjianStephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, Minnesota View All Author Informationhttps://doi.org/10.1016/j.juro.2012.04.020AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated the clinicopathological outcomes of patients treated with cystectomy for pure urothelial carcinoma vs urothelial carcinoma, and squamous and/or glandular differentiation. Materials and Methods: We reviewed the records of 1,013 patients who underwent radical cystectomy, including 827 (72%) with pure urothelial carcinoma and 186 (18%) with urothelial carcinoma, and squamous and/or glandular differentiation. Of patients with variant histology 132 had squamous differentiation, 41 had glandular features and 13 had each type. Cancer specific survival was estimated using the Kaplan-Meier method. The association of histological differentiation with death from bladder cancer was evaluated using multivariate Cox proportional hazard regression analysis. Results: Patients with urothelial carcinoma, and squamous and/or glandular differentiation were more likely to have pT3-T4 tumors (70% vs 38%, p <0.0001) and pN+ disease (20% vs 15%, p = 0.05) than those with pure urothelial carcinoma. Median followup was 11.4 years. A total of 432 patients died of bladder cancer, including 77 with histological differentiation and 355 with pure urothelial carcinoma. Ten-year cancer specific survival did not significantly differ between patients with urothelial carcinoma and histological differentiation, and those with pure urothelial carcinoma (52% vs 51%, p = 0.71). After adjusting for clinicopathological features squamous and/or glandular differentiation was not significantly associated with the risk of death from bladder cancer (HR 0.79, p = 0.10). 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Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHajiran A, Azizi M, Aydin A, Zemp L, Peyton C, Dhillon J, Nealon S, Reich R, Cao B, Li R, Manley B, Sexton W and Gilbert S (2020) Pathological and Survival Outcomes Associated with Variant Histology Bladder Cancers Managed by Cystectomy with or without Neoadjuvant ChemotherapyJournal of Urology, VOL. 205, NO. 1, (100-108), Online publication date: 1-Jan-2021.Mori K, Abufaraj M, Mostafaei H, Quhal F, Karakiewicz P, Briganti A, Kimura S, Egawa S and Shariat S (2020) A Systematic Review and Meta-Analysis of Variant Histology in Urothelial Carcinoma of the Bladder Treated with Radical CystectomyJournal of Urology, VOL. 204, NO. 6, (1129-1140), Online publication date: 1-Dec-2020.Yang D, Monn M, Kaimakliotis H, Cho J, Cary K, Pedrosa J, Bihrle R, Cheng L and Koch M (2015) Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?Urology Practice, VOL. 2, NO. 6, (335-342), Online publication date: 1-Nov-2015.Linder B, Boorjian S, Cheville J, Sukov W, Thapa P, Tarrell R and Frank I (2013) The Impact of Histological Reclassification during Pathology Re-Review—Evidence of a Will Rogers Effect in Bladder Cancer?Journal of Urology, VOL. 190, NO. 5, (1692-1697), Online publication date: 1-Nov-2013. Volume 188Issue 2August 2012Page: 405-409 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordshistologyurotheliumcarcinomaurinary bladder neoplasmsmortalityMetrics Author Information Simon P. Kim Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Igor Frank Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author John C. Cheville Department of Pathology, Mayo Clinic, Rochester, Minnesota More articles by this author R. Houston Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Christopher J. Weight Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Prabin Thapa Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author Stephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Expand All Advertisement PDF downloadLoading ...