Prognostic impact of variant histology in bladder cancer: Would early and aggressive treatment shift the paradigm?
Urol Oncol
; 42(5): 161.e1-161.e8, 2024 May.
Article
in En
| MEDLINE
| ID: mdl-38267300
ABSTRACT
INTRODUCTION:
Bladder cancer (BC) is an increasingly frequent malignancy worldwide. Several variant histologies (VH) have been described in BC with a distinct clinical behavior.OBJECTIVES:
This study aims to assess the prognostic impact of VH in BC, comparing its outcomes to pure urothelial carcinoma PUC in both non-muscle invasive (NMIBC) and muscle-invasive (MIBC) settings.METHODS:
We included patients with primary BC, comparing those with VH with those with PUC, with an age and sex-matched proportion of 13, considering stage at diagnosis, recurrence-free, progression-free, and overall survival (OS). A total of 616 patients were included in the study, (460 UC and 151 VH).RESULTS:
After first TURBT, MIBC was present in 99 (64.1%) of patients with VH, and 95 (20.6%) with UC (p<0.001). Concerning NMIBC, we observed higher rates of progression to MIBC amid patients with VH (p=0.009). Nodal involvement (p=0.020) and metastatic disease (p<0.001) were significantly higher within the VH group. A higher OS was observed among patients with NMIBC of PUC (p<0.001). There were no statistically significant differences of metastasis-free survival and OS between VH and UC groups within the MIBC setting.CONCLUSION:
We confirmed that VH presents a more aggressive clinical course compared to PUC. An earlier radical treatment within the NMIBC setting could increase the oncological outcomes of the VH patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Urinary Bladder Neoplasms
/
Carcinoma, Transitional Cell
/
Non-Muscle Invasive Bladder Neoplasms
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Urol Oncol
Journal subject:
NEOPLASIAS
/
UROLOGIA
Year:
2024
Document type:
Article
Country of publication:
Estados Unidos