Clinical and Genomic Considerations for Variant Histology in Bladder Cancer

Matulay, Justin T.; Narayan, Vikram M.; Kamat, Ashish M.

doi:10.1007/s11912-019-0772-8

Cited by 17 publications

(14 citation statements)

References 69 publications

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“…Mitra et al (15), in a recent multiinstitutional study, analyzed 41 patients with micropapillary urothelial carcinoma (MUC) treated with AC, who obtained improved recurrence free survival and OS (P<0.01) from different AC regimens. The lack of a benefit in survival outcomes from AC in the SCC, the sarcomatoid differentiation and the adenocarcinoma is aligned with previous discoveries and underlines the limited effectiveness of chemotherapy regimens in these aggressive entities (16)(17)(18). Conversely, the absence of a significant improvement from AC in OS in the neuroendocrine variant is in contrast with previous results, which have highlighted the chemosensitive nature of this histology, both in the neoadjuvant and the adjuvant setting (17).…”

Section: Editorial Commentarysupporting

confidence: 71%

“…A sub stratification per type of chemotherapy regimen might help to identify better performing drug combinations. Fifth, this study lacks insight about molecular features, which are increasingly demonstrating a potential role in the diagnostic workup, prognosis definition and treatment selection (18,25). Due to these limitations, it is not possible to infer generalizable conclusions from this investigation.…”

Section: Editorial Commentarymentioning

confidence: 92%

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Adjuvant chemotherapy in bladder cancer patients with histological variants: time to change the approach?

Afferi

Zamboni

Baumeister

et al. 2019

Transl. Androl. Urol

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Section: Editorial Commentarysupporting

confidence: 71%

Section: Editorial Commentarymentioning

confidence: 92%

Adjuvant chemotherapy in bladder cancer patients with histological variants: time to change the approach?

Afferi

Zamboni

Baumeister

et al. 2019

Transl. Androl. Urol

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“…Data from the literature point out that consensus agreement between pathologists in recognizing VH-UC is less than optimal, even when asking renowned experts in the field. Diagnosing VH-UC at TURB may be further affected by many factors, including the availability of only a small amount of tissue with inherent risk of undersampling, the frequent occurrence of coagulation artifacts, and tumor heterogeneity [24,34,35]. In keeping with this, there have been discordant results when evaluating the accuracy of TURB in assessing the occurrence and type of VH.…”

Section: Bc With Vh: Overall Featuresmentioning

confidence: 99%

“…On the basis of such evidence, early RC is currently advocated as the optimal treatment option for MV-NMIBC over conservative therapy [33,37,42,45,52,98,109,121,124,125], with NAC for select patients [34]. Accordingly, a survey developed by the Translational Science Working Group of the Bladder Cancer Advocacy Network-sponsored think tank meeting distributed to members of the Society of Urologic Oncology (SUO) reported that the early RC would be the treatment choice of cT1 MV-UC for 81% of the participants [126], and the statement proposing immediate RC and lymphadenectomy for T1 HG MV-UC (diagnosed upon complete TUR and/or re-TUR) was accepted with an agreement rate as high as 86% in a recent EAU-ESMO consensus meeting [78].…”

Section: Micropapillary Variantmentioning

confidence: 99%

Non-Muscle Invasive Bladder Cancer with Variant Histology: Biological Features and Clinical Implications

et al. 2021

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Background: The most common bladder cancer (BC) histotype is pure urothelial carcinoma (UC), which may undergo divergent differentiation in some cases. Variant histology (VH) presents along variable morphologies, either single or combined between them or with pure UC. From a clinical standpoint, the vast majority of BC is diagnosed at non-invasive or minimally invasive stages, namely as non-muscle invasive BC (NMIBC). There is a wide range of therapeutic options for patients with NMIBC, according to their clinical and pathological features. However, current risk stratification models do not show optimal effectiveness. Evidence from the literature suggests that VH has peculiar biological features, and may be associated with poorer survival outcomes compared to pure UC. Summary: In order to describe the biological features and prognostic/predictive role of VH in NMIBC, and to discuss current treatment options, we performed a systematic literature search through multiple databases (PubMed/Medline, Google Scholar) for relevant articles according to the following terms, single and/or in combination: “non-muscle invasive bladder cancer,” “variant histology,” “micropapillary variant,” “glandular differentiation,” “squamous differentiation,” “nested variant,” “plasmacytoid variant,” and “sarcomatoid variant.” We extracted 99 studies including original articles, reviews, and systematic reviews, and subsequently analyzed data from 16 studies reporting on the outcome of NMIBC with VH. We found that the relative rarity of these forms as well as the heterogeneity in study populations and therapeutic protocols results in conflicting findings overall. Key Messages: The presence of VH should be taken into account when counseling a patient with NMIBC, since it may upgrade the disease to high-risk tumor and thus warrant a more aggressive treatment.

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“…The variant histology carries worse prognosis than pure UC. These tumors present at a higher stage and are more likely to develop metastatic disease [3]. The outcomes varied with divergent histologies and appropriate treatment should be based on the histological finding [4].…”

Section: Introductionmentioning

confidence: 99%

Expression of GATA3 and Cytokeratin 14 in Urinary Bladder Carcinoma (Histopathological and Immunohistochemical Study)

Elzohery

Ismael

Khairy

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: Urothelial carcinoma (UC) with squamous differentiation (SD) is the most common histologic variant of bladder carcinoma and its presence is associated with poor prognosis which may need early radical cystectomy to avoid progression and recurrence. It is difficult to detect few foci of SD, especially nonkeratinizing or early switch from urothelial to squamous epithelium on only morphological basis. Combination of GATA3 and Cytokeratin 14 (CK14) could be helpful in differentiating pure UC, UC with SD and pure squamous cell carcinoma (SCC). AIM: Assessment of GATA3 and CK14 expression in urinary bladder carcinoma and correlation with clinical and histopathological variables, for both diagnostic and prognostic purposes. MATERIALS AND METHODS: Sixty cases of archived paraffin blocks of urinary bladder carcinoma were tested for GATA3 and CK14 expression by immunohistochemistry using a rabbit monoclonal antibody against human CK 14 and mouse monoclonal antibody against GATA3, respectively. RESULTS: There is a significant correlation between GATA3 immunohistochemical expression and histological tumor subtypes of bladder carcinoma (p < 0.001), i.e. the GATA3 is a useful marker for urothelial origin especially in papillary UC. There is a significant correlation between GATA3 immunohistochemical expression and UC grade (p < 0.001). CK14 showed positive cytoplasmic staining in 9/14 (64.3%) cases of UC with SD and (13/13) (100%) cases of pure SCC and negative in 33/33(100%) cases of UC other than UC with SD. CK14 had sensitivity (64.3%) and specificity (100%) for areas of SD. CONCLUSION: GATA3 is a specific immunohistochemical marker for urothelial origin. CK14 is a highly specific and sensitive immunohistochemical marker of squamous cell carcinoma.

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Clinical and Genomic Considerations for Variant Histology in Bladder Cancer

Cited by 17 publications

References 69 publications

Adjuvant chemotherapy in bladder cancer patients with histological variants: time to change the approach?

Adjuvant chemotherapy in bladder cancer patients with histological variants: time to change the approach?

Non-Muscle Invasive Bladder Cancer with Variant Histology: Biological Features and Clinical Implications

Expression of GATA3 and Cytokeratin 14 in Urinary Bladder Carcinoma (Histopathological and Immunohistochemical Study)

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