Clinicopathologic and Survival After Cystectomy Outcomes in Squamous Cell Carcinoma of the Bladder.


Journal

Clinical genitourinary cancer
ISSN: 1938-0682
Titre abrégé: Clin Genitourin Cancer
Pays: United States
ID NLM: 101260955

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 19 02 2023
revised: 25 05 2023
accepted: 26 05 2023
medline: 27 11 2023
pubmed: 20 6 2023
entrez: 19 6 2023
Statut: ppublish

Résumé

Squamous cell carcinoma of the bladder (SqCC) is a rare disease with limited management data. Thus, we sought to characterize the clinicopathologic and survival outcomes amongst patients with SqCC and explore the association of squamous differentiation within urothelial carcinoma (UC w/Squam), as compared to muscle invasive pure UC. We conducted a single-center retrospective cohort study of patients, stratified by histology, who underwent cystectomy for MIBC. Baseline clinicopathologic characteristics were compared, and overall survival was assessed using Kaplan-Meier method. We identified 1,034 patients; 37 (3.58%) with SqCC histology, 908 (87.81%) with UC histology, and 89 (8.61%) with UC w/ Squam histology. Among SqCC patients, a higher proportion were Black and similarly a higher proportion were women; amongst patients with UC w/ Squam a higher proportion had lower BMI; and amongst patients with UC a higher proportion had lower clinical (c) T, cN, pathological (p) T, and pN stages. Patients presenting with UC were more likely to receive intravesical therapy; patients presenting with SqCC were less likely to receive neoadjuvant chemotherapy (NAC). Adjuvant chemotherapy rates were similar. With post-hoc Bonferroni analysis, overall survival, cancer-specific survival, and recurrence-free survival were significantly worse for the UC w/ Squam cohort. UC w/ Squam histology was associated with worse survival outcomes after cystectomy for muscle invasive bladder cancer compared to UC. Our results suggest that UC w/ Squam is associated with more advanced disease compared to UC, warranting further prospective work on consideration of combination therapies for patients with this disease state.

Sections du résumé

BACKGROUND BACKGROUND
Squamous cell carcinoma of the bladder (SqCC) is a rare disease with limited management data. Thus, we sought to characterize the clinicopathologic and survival outcomes amongst patients with SqCC and explore the association of squamous differentiation within urothelial carcinoma (UC w/Squam), as compared to muscle invasive pure UC.
METHODS METHODS
We conducted a single-center retrospective cohort study of patients, stratified by histology, who underwent cystectomy for MIBC. Baseline clinicopathologic characteristics were compared, and overall survival was assessed using Kaplan-Meier method.
RESULTS RESULTS
We identified 1,034 patients; 37 (3.58%) with SqCC histology, 908 (87.81%) with UC histology, and 89 (8.61%) with UC w/ Squam histology. Among SqCC patients, a higher proportion were Black and similarly a higher proportion were women; amongst patients with UC w/ Squam a higher proportion had lower BMI; and amongst patients with UC a higher proportion had lower clinical (c) T, cN, pathological (p) T, and pN stages. Patients presenting with UC were more likely to receive intravesical therapy; patients presenting with SqCC were less likely to receive neoadjuvant chemotherapy (NAC). Adjuvant chemotherapy rates were similar. With post-hoc Bonferroni analysis, overall survival, cancer-specific survival, and recurrence-free survival were significantly worse for the UC w/ Squam cohort.
CONCLUSIONS CONCLUSIONS
UC w/ Squam histology was associated with worse survival outcomes after cystectomy for muscle invasive bladder cancer compared to UC. Our results suggest that UC w/ Squam is associated with more advanced disease compared to UC, warranting further prospective work on consideration of combination therapies for patients with this disease state.

Identifiants

pubmed: 37336703
pii: S1558-7673(23)00138-6
doi: 10.1016/j.clgc.2023.05.019
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

631-638.e1

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure All other authors state that they have no conflicts of interest.

Auteurs

Pranjal Agrawal (P)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Mary Rostom (M)

Department of Urology, Desai Sethi Urology Institute, Miller School of Medicine, Miami, FL.

Ridwan Alam (R)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Isabella Florissi (I)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Michael Biles (M)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Katherine Rodriguez (K)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Noah M Hahn (NM)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.

Burles A Johnson (BA)

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.

Andres Matoso (A)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.

Armine Smith (A)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Trinity J Bivalacqua (TJ)

Department of Urology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA.

Max Kates (M)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD.

Jeannie Hoffman-Censits (J)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.

Sunil H Patel (SH)

Department of Urology, The James Buchannan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: spate167@jhmi.edu.

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