Abstract
Introduction: Interest on the impact of variant histology in bladder cancer prognosis is increasing. Although squamous differentiation is the most well characterized, only recently have less common variants gained increased recognition. We assessed whether squamous differentiation conferred a worse prognosis than nonvariant urothelial bladder cancer in a contemporary cohort of patients treated with radical cystectomy given the increased awareness of other less common variants. Methods: We identified patients with squamous differentiation or nonvariant histology on transurethral resection of bladder tumor and/or cystectomy pathology during a 10-year period. Disease specific and overall survival were evaluated using Kaplan-Meier methodology. Cox regression was used to assess variables associated with mortality. Results: Between 2003 and 2013, 934 patients underwent cystectomy for urothelial bladder cancer. Overall 617 nonvariant and 118 squamous differentiation cases were identified, and the remainder was nonsquamous differentiation variant histology. Overall 75% of patients with squamous differentiation had muscle invasive disease at diagnosis compared with 59% of those with nonvariant histology (p=0.002). Nonorgan confined disease at cystectomy was more common in patients with squamous differentiation (57% vs 44%, p=0.009). Among cases on neoadjuvant chemotherapy 20% (9 of 45) of nonvariant and 13% (1 of 8) of squamous differentiation were pT0N0 (p=0.527). Median followup was 52 months. Adjusted for demographics, pathological stage and chemotherapy, squamous differentiation was not associated with an increased risk of disease specific (HR 1.35, 95% CI 0.90-2.04, p=0.150) or all cause mortality (HR 0.90, 95% CI 0.60-1.25, p=0.515). Conclusions: In a contemporary cohort of urothelial bladder cancer with recognition and characterization of less commonly described variants, squamous differentiation is not associated with a worse disease specific and all cause mortality when compared to a pure nonvariant cohort.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 335-341 |
| Number of pages | 7 |
| Journal | Urology Practice |
| Volume | 2 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 1 2015 |
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Keywords
- Carcinoma
- Cystectomy
- Outcome assessment (health care)
- Pathology
- Surgical
- Transitional cell
- Urinary bladder neoplasms
ASJC Scopus subject areas
- Urology
Cite this
Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer? / Yang, David Y.; Monn, M. Francesca; Kaimakliotis, Hristos; Cho, Jane S.; Cary, K. Clinton; Pedrosa, Jose A.; Bihrle, Richard; Cheng, Liang; Koch, Michael.
In: Urology Practice, Vol. 2, No. 6, 01.11.2015, p. 335-341.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?
AU - Yang, David Y.
AU - Monn, M. Francesca
AU - Kaimakliotis, Hristos
AU - Cho, Jane S.
AU - Cary, K. Clinton
AU - Pedrosa, Jose A.
AU - Bihrle, Richard
AU - Cheng, Liang
AU - Koch, Michael
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Introduction: Interest on the impact of variant histology in bladder cancer prognosis is increasing. Although squamous differentiation is the most well characterized, only recently have less common variants gained increased recognition. We assessed whether squamous differentiation conferred a worse prognosis than nonvariant urothelial bladder cancer in a contemporary cohort of patients treated with radical cystectomy given the increased awareness of other less common variants. Methods: We identified patients with squamous differentiation or nonvariant histology on transurethral resection of bladder tumor and/or cystectomy pathology during a 10-year period. Disease specific and overall survival were evaluated using Kaplan-Meier methodology. Cox regression was used to assess variables associated with mortality. Results: Between 2003 and 2013, 934 patients underwent cystectomy for urothelial bladder cancer. Overall 617 nonvariant and 118 squamous differentiation cases were identified, and the remainder was nonsquamous differentiation variant histology. Overall 75% of patients with squamous differentiation had muscle invasive disease at diagnosis compared with 59% of those with nonvariant histology (p=0.002). Nonorgan confined disease at cystectomy was more common in patients with squamous differentiation (57% vs 44%, p=0.009). Among cases on neoadjuvant chemotherapy 20% (9 of 45) of nonvariant and 13% (1 of 8) of squamous differentiation were pT0N0 (p=0.527). Median followup was 52 months. Adjusted for demographics, pathological stage and chemotherapy, squamous differentiation was not associated with an increased risk of disease specific (HR 1.35, 95% CI 0.90-2.04, p=0.150) or all cause mortality (HR 0.90, 95% CI 0.60-1.25, p=0.515). Conclusions: In a contemporary cohort of urothelial bladder cancer with recognition and characterization of less commonly described variants, squamous differentiation is not associated with a worse disease specific and all cause mortality when compared to a pure nonvariant cohort.
AB - Introduction: Interest on the impact of variant histology in bladder cancer prognosis is increasing. Although squamous differentiation is the most well characterized, only recently have less common variants gained increased recognition. We assessed whether squamous differentiation conferred a worse prognosis than nonvariant urothelial bladder cancer in a contemporary cohort of patients treated with radical cystectomy given the increased awareness of other less common variants. Methods: We identified patients with squamous differentiation or nonvariant histology on transurethral resection of bladder tumor and/or cystectomy pathology during a 10-year period. Disease specific and overall survival were evaluated using Kaplan-Meier methodology. Cox regression was used to assess variables associated with mortality. Results: Between 2003 and 2013, 934 patients underwent cystectomy for urothelial bladder cancer. Overall 617 nonvariant and 118 squamous differentiation cases were identified, and the remainder was nonsquamous differentiation variant histology. Overall 75% of patients with squamous differentiation had muscle invasive disease at diagnosis compared with 59% of those with nonvariant histology (p=0.002). Nonorgan confined disease at cystectomy was more common in patients with squamous differentiation (57% vs 44%, p=0.009). Among cases on neoadjuvant chemotherapy 20% (9 of 45) of nonvariant and 13% (1 of 8) of squamous differentiation were pT0N0 (p=0.527). Median followup was 52 months. Adjusted for demographics, pathological stage and chemotherapy, squamous differentiation was not associated with an increased risk of disease specific (HR 1.35, 95% CI 0.90-2.04, p=0.150) or all cause mortality (HR 0.90, 95% CI 0.60-1.25, p=0.515). Conclusions: In a contemporary cohort of urothelial bladder cancer with recognition and characterization of less commonly described variants, squamous differentiation is not associated with a worse disease specific and all cause mortality when compared to a pure nonvariant cohort.
KW - Carcinoma
KW - Cystectomy
KW - Outcome assessment (health care)
KW - Pathology
KW - Surgical
KW - Transitional cell
KW - Urinary bladder neoplasms
UR - http://www.scopus.com/inward/record.url?scp=84945279450&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84945279450&partnerID=8YFLogxK
U2 - 10.1016/j.urpr.2015.02.003
DO - 10.1016/j.urpr.2015.02.003
M3 - Article
AN - SCOPUS:84945279450
VL - 2
SP - 335
EP - 341
JO - Urology Practice
JF - Urology Practice
SN - 2352-0779
IS - 6
ER -