The effect of squamous and/or glandular differentiation on recurrence, progression and survival in urothelial carcinoma of bladder

Abstract

Introduction The effects of squamous and/or glandular differentiation in urothelial carcinoma of bladder on recurrence, progression and survival rate were evaluated in this study. Patients and methods Between 1998 and 2003, a total of 223 patients who had been treated with transurethral resection for bladder cancers were evaluated. The patients were divided into two groups as; Group I: tumor patients with squamous and/or glandular differentiation, Group II: patients without these findings. Results Histologically 189 (84.7%) were conventional urothelial carcinoma and 34 (15.2%) were tumors with squamous and/or glandular differentiation. The mean age of the patients was 64.4 ± 12.7 (range 36-81) years. Survival rates within a period of 46.23 ± 14.8 (12-67) months were 76.47% for Group I and 89.94% for Group II (P = 0.027). The stage distribution as pTa, pT1, and ‡pT2 was 2 (5.9%), 18 (52.9%), and 14 (41.2%) in Group I and 101 (53.4%), 51 (27%) and 37 (19.6%) in group II, respectively (P = 0.001). There was a statistically significant tendency towards higher stage at presentation in Group I and the grade distribution was significantly higher in Group I than Group II (P < 0.001). Conclusion High recurrence rates and poor prognosis of these patients should be kept in mind in the follow-up period. In this respect, these patients should be followed up closely.

Dysplastic Squamous Cells Are Frequently Present in Urine Cytology Specimens of Patients with High-Grade Urothelial Carcinoma

“…In an earlier study evaluating transurethral resection specimens, Billis and coworkers [9] identified the presence of squamous and/or glandular differentiation in up to 7.2% of cases which had a higher stage at presentation compared to the group without this differentiation. These findings were reaffirmed by Erdemir and coworkers [12] who examined all UCAs with inferior survival. More recently, UCAs of the renal pelvis have also been reported to show SqD [1].…”

Histologic variants of urothelial bladder cancer and nonurothelial histology in bladder cancer

“…They noted higher recurrence and progression rates. 17 Honma and colleagues, in a study of 27 patients with local recurrence after radical cystectomy, found that any element of squamous differentiation was the only independent predictor of local recurrence in multivariate analysis. 18 In contrast, Lopez-Beltran and colleagues found the presence of squamous differentiation to have no effect on survival; they did note, however, that it was correlated with higher grade and stage.…”

Different immunohistochemical and ultrastructural phenotypes of squamous differentiation in bladder cancer

“…Interestingly, in western countries, up to 50% of poorly differentiated advanced urothelial carcinomas show an additional squamous differentiation component (mixed UC/SCC) [3]. In a study on transurethral resections, this squamous (and/or glandular) differentiation in invasive UCs was associated with advanced tumour stage (>/=pT2 41.2% versus 19.6% pure UC), significantly different recurrence rates (70% versus 42% pure UC), progression rates (35% versus 9.2% pure UC) and mean survival rates (76.5% versus 90.0% pure UC, follow-up period of up to 5 years) [4]. Therefore, a reliable characterisation by histology and immunohistochemistry is important for the further selection of treatment options.…”