Sarcomatoid Urothelial Carcinoma Is Associated With Limited Response to Neoadjuvant Chemotherapy and Poor Oncologic Outcomes After Radical Cystectomy

Sekar, Rishi; Diamantopoulos, Leonidas; Bakaloudi, Dimitra Rafailia; Khaki, Ali Raza; Grivas, Petros; Winters, Brian; Vakar-López, Funda; Tretiakova, Maria; Psutka, Sarah P.; Holt, Sarah K.; Gore, John L.; Lin, Daniel W.; Schade, George R.; Hsieh, Andrew C.; Lee, John K.; Yezefski, Todd; Schweizer, Michael T.; Cheng, Heather H.; Yu, Evan Y.; True, Lawrence D.; Montgomery, Bruce; Wright, Jonathan L.

doi:10.1016/j.clgc.2023.03.015

Clinical Genitourinary Cancer

2023

DOI: 10.1016/j.clgc.2023.03.015

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Sarcomatoid Urothelial Carcinoma Is Associated With Limited Response to Neoadjuvant Chemotherapy and Poor Oncologic Outcomes After Radical Cystectomy

Rishi Sekar¹,

Leonidas Diamantopoulos²,

Dimitra Rafailia Bakaloudi³

et al.

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2024

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Cited by 2 publications

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Adjuvant Chemotherapy and Survival After Radical Cystectomy in Histologic Subtype Bladder Cancer

Koehne,

Bakaloudi,

Ghali

et al. 2024

Clinical Genitourinary Cancer

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Adjuvant Chemotherapy and Survival After Radical Cystectomy in Histologic Subtype Bladder Cancer

Koehne,

Bakaloudi,

Ghali

et al. 2024

Clinical Genitourinary Cancer

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Prognostic impact of histological discordance between transurethral resection and radical cystectomy

Matsuda,

Taoka,

Miki

et al. 2024

BJU International

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ObjectiveTo analyse the impact of histological discordance of subtypes (subtypes or divergent differentiation [DD]) in specimens from transurethral resection (TUR) and radical cystectomy (RC) on the outcome of the patients with bladder cancer receiving RC.Patients and methodsWe analysed data for 2570 patients from a Japanese nationwide cohort with bladder cancer treated with RC between January 2013 and December 2019 at 36 institutions. The non‐urinary tract recurrence‐free survival (NUTR‐FS) and overall survival (OS) stratified by TUR or RC specimen histology were determined. We also elucidated the predictive factors for OS in patients with subtype/DD bladder cancer.ResultsAt median follow‐up of 36.9 months, 835 (32.4%) patients had NUTR, and 691 (26.9%) died. No statistically significant disparities in OS or NUTR‐FS were observed when TUR specimens were classified as pure‐urothelial carcinoma (UC), subtypes, DD, or non‐UC. Among 2449 patients diagnosed with pure‐UC or subtype/DD in their TUR specimens, there was discordance between the pathological diagnosis in TUR and RC specimens. Histological subtypes in RC specimens had a significant prognostic impact. When we focused on 345 patients with subtype/DD in TUR specimens, a multivariate Cox regression analysis identified pre‐RC neutrophil–lymphocyte ratio and pathological stage as independent prognostic factors for OS (P = 0.016 and P = 0.001, respectively). The presence of sarcomatoid subtype in TUR specimens and lymphovascular invasion in RC specimens had a marginal effect (P = 0.069 and P = 0.056, respectively).ConclusionThis study demonstrated that the presence of subtype/DD in RC specimens but not in TUR specimens indicated a poor prognosis. In patients with subtype/DD in TUR specimens, pre‐RC neutrophil–lymphocyte ratio and pathological stage were independent prognostic factors for OS.

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Sarcomatoid Urothelial Carcinoma Is Associated With Limited Response to Neoadjuvant Chemotherapy and Poor Oncologic Outcomes After Radical Cystectomy

Cited by 2 publications

References 20 publications

Adjuvant Chemotherapy and Survival After Radical Cystectomy in Histologic Subtype Bladder Cancer

Adjuvant Chemotherapy and Survival After Radical Cystectomy in Histologic Subtype Bladder Cancer

Prognostic impact of histological discordance between transurethral resection and radical cystectomy

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