Outcomes Following Radical Cystectomy for Nested Variant of Urothelial Carcinoma: A Matched Cohort Analysis

Linder, Brian J.; Frank, Igor; Cheville, John C.; Thompson, R. Houston; Thapa, Prabin; Tarrell, Robert F.; Boorjian, Stephen A.

doi:10.1016/j.juro.2012.11.006

Cited by 88 publications

(57 citation statements)

References 10 publications

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“…Linder and associates [22] evaluated the oncological outcomes after radical cystectomy in patients with nested variant of urothelial carcinoma and compared survival to that in patients with pure urothelial carcinoma of the bladder. Linder and associates [22] identified 52 patients with nested variant of urothelial carcinoma of the urinary bladder who were treated with radical cystectomy between 1980 and 2004.…”

Section: Results/literature Reviewmentioning

confidence: 99%

Nested Variant of Urothelial Carcinoma

Venyo

2014

Advances in Urology

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Background. Nested variant of urothelial carcinoma was added to the WHO's classification in 2004. Aims. To review the literature on nested variant of urothelial carcinoma. Results. About 200 cases of the tumour have been reported so far and it has the ensuing morphological features: large numbers of small confluent irregular nests of bland-appearing, closely packed, haphazardly arranged, and poorly defined urothelial cells infiltrating the lamina propria and the muscularis propria. The tumour has a bland histomorphologic appearance, has an aggressive biological behaviour, and has at times been misdiagnosed as a benign lesion which had led to a significant delay in the establishment of the correct diagnosis and contributing to the advanced stage of the disease. Immunohistochemically, the tumour shares some characteristic features with high-risk conventional urothelial carcinomas such as high proliferation index and loss of p27 expression. However, p53, bcl-2, or EGF-r immunoreactivity is not frequently seen. The tumour must be differentiated from a number of proliferative lesions of the urothelium. Conclusions. Correct and early diagnosis of this tumour is essential to provide early curative treatment to avoid diagnosis at an advanced stage. A multicentre trial is required to identify treatment options that would improve the outcome of this tumour.

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Section: Results/literature Reviewmentioning

confidence: 99%

Nested Variant of Urothelial Carcinoma

Venyo

2014

Advances in Urology

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“…5a, Table 2). Urothelial carcinoma has long been known to have a remarkable propensity for divergent differentiation, which is seen most commonly in association with high-grade and locally advanced disease [59][60][61][62]. The incidence of divergent differentiation in cystectomy specimens is as high as 33%.…”

Section: Invasive Urothelial Carcinoma With Divergent Differentiationmentioning

confidence: 99%

The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs—Part B: Prostate and Bladder Tumours

et al. 2016

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It has been 12 yr since the publication of the last World Health Organization (WHO) classification of tumours of the prostate and bladder. During this time, significant new knowledge has been generated about the pathology and genetics of these tumours. Intraductal carcinoma of the prostate is a newly recognized entity in the 2016 WHO classification. In most cases, it represents intraductal spread of aggressive prostatic carcinoma and should be separated from high-grade prostatic intraepithelial neoplasia. New acinar adenocarcinoma variants are microcystic adenocarcinoma and pleomorphic giant cell adenocarcinoma. Modifications to the Gleason grading system are incorporated into the 2016 WHO section on grading of prostate cancer, and it is recommended that the percentage of pattern 4 should be reported for Gleason score 7. The new WHO classification further recommends the recently developed prostate cancer grade grouping with five grade groups. For bladder cancer, the 2016 WHO classification continues to recommend the 1997 International Society of Urological Pathology grading classification. Newly described or better defined noninvasive urothelial lesions include urothelial dysplasia and urothelial proliferation of uncertain malignant potential, which is frequently identified in patients with a prior history of urothelial carcinoma. Invasive urothelial carcinoma with divergent differentiation refers to tumours with some percentage of "usual type" urothelial carcinoma combined with other morphologies. Pathologists should mention the percentage of divergent histologies in the pathology report. PATIENT SUMMARY Intraductal carcinoma of the prostate is a newly recognized entity in the 2016 World Health Organization classification. Better defined noninvasive urothelial lesions include urothelial dysplasia and urothelial proliferation of uncertain malignant potential. v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j AbstractIt has been 12 yr since the publication of the last World Health Organization (WHO) classification of tumours of the prostate and bladder. During this time, significant new knowledge has been generated about the pathology and genetics of these tumours.

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“…5 As has been consistent with other variants of bladder cancer, most studies show a predisposition to present with advanced disease compared with conventional UC with high rates of muscle invasion at TUR (70% vs 31%), extravesical disease (83% vs 33%), and metastasis (67% vs 19%) when compared with high-grade UC, respectively. 33,34 Nevertheless, stage for stage, NV does not seem to be any more aggressive than conventional UC with matched cohort analyses (n 5 52) showing that, despite high rates of locally advanced (69%) and node-positive (19%) disease (10-year cancer-specific survival of 41%), NV has equivalent survival outcomes after controlling for pathologic stage. 32 There is very little published regarding the efficacy of neoadjuvant chemotherapy for NV.…”

Section: Nested Variantmentioning

confidence: 98%