Sarcomatoid Urothelial Carcinoma of the Bladder: Analysis of 28 Cases With Emphasis on Clinicopathologic Features and Markers of Epithelial-to-Mesenchymal Transition

Abstract

-Sarcomatoid UCa is an aggressive form of UCa that frequently expresses epithelial-to-mesenchymal transition markers, suggesting a possible mechanism associated with aggressive tumor behavior.

Dysregulation of EMT Drives the Progression to Clinically Aggressive Sarcomatoid Bladder Cancer

“…In the United States, there were approximately 17,000 deaths related to bladder cancer in 2018 (Siegel et al, 2018). Progression to SARC is associated with a high propensity for early metastasis and dismal 5-year survival rates (Amin, 2009; Lopez-Beltran et al, 1998; Sanfrancesco et al, 2016). In the following, we highlight essential findings concerning molecular characterizations of SARC and suggest how these findings may contribute to our understanding of its aggressive behavior as well as how they open therapeutic possibilities.…”

“…These features combined with overexpression of immune checkpoint receptors and their ligands, including PD-L1, suggest opportunities for immune checkpoint therapy for a subset of patients with SARC, which are typically resistant to conventional cisplatin-based chemotherapies (Kamat et al, 2016; Lopez-Beltran et al, 1998; Sanfrancesco et al, 2016). …”

“…SARC represents, in various published series, 5%–15% of bladder cancer and frequently coexists with conventional UC (Lopez-Beltran et al, 1998; Sanfrancesco et al, 2016). Clinically, it has a predilection for early metastatic spread to distant organs, and it is associated with shorter survival compared with conventional UC (Amin, 2009; Lopez-Beltran et al, 1998; Sanfrancesco et al, 2016). Here, we report on the genome-wide characterization of bladder SARC, including its miRNA, gene expression, and whole-exome mutational profiles, which identified molecular features associated with its aggressive nature that may be relevant for the early detection and treatment of this highly lethal variant of bladder cancer.…”

Variants and new entities of bladder cancer

“…Sarcomatoid urothelial carcinoma frequently presents as advanced disease and has a poor outcome . Pathological stage seems to be the best predictor of survival in sarcomatoid carcinoma .…”

Sarcomatoid urothelial carcinoma with disseminated metastases: an aggressive and rare cancer

“…The tumour has both epithelial and mesenchymal components, hence previously termed carcinosarcoma 2. Therefore, the diagnosis requires a board panel of immunohistochemical stains to demonstrate both components which represent the process of epithelial-to-mesenchymal transition 2. There is still no standardised therapeutic protocol available because of the small reported cases and lack of clinical trials 3…”