Urothelial Carcinoma with Divergent Histologic Differentiation (Mixed Histologic Features) Predicts the Presence of Locally Advanced Bladder Cancer When Detected at Transurethral Resection

Wasco, Matthew J.; Daignault, Stephanie; Zhang, Yingxi; Kunju, Lakshmi P.; Kinnaman, Michael D.; Braun, Thomas; Lee, Cheryl T.; Shah, Rajal B.

doi:10.1016/j.urology.2007.03.033

Cited by 200 publications

(166 citation statements)

References 23 publications

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“…Furthermore, on Cox proportional hazards regression, only pathologic staging and LN status were associated with increased risk of disease specific and all-cause mortality. Our findings are consistent with previously reported studies that have shown that SQD does not portend worse survival on multivariate analysis 6,7,11,23 .…”

Section: Discussionsupporting

confidence: 93%

“…While much has been published on SQD, the true prevalence of SQD tumors is TURBT to be less dramatic but still significant in a cohort of radical cystectomy patients 6 . They reported 85.7% of SQD patients and 52.3% of NV patients having muscle invasive disease.…”

Section: Discussionmentioning

confidence: 99%

“…Collectively, variant histology is often associated with more advanced disease and worse survival [3][4][5][6] . Nonetheless, the heterogeneity of urothelial bladder cancer and the ability to display clinicopathologic characteristics of single or multiple variant subtypes has complicated the understanding of variant tumor biology even further.…”

Section: Introductionmentioning

confidence: 99%

“…As one of the first classified variants, squamous differentiation (SQD) has consistently been described as the most common variant subtype, comprising anywhere between 30-80% of variant bladder cancers 2,3,[6][7][8][9][10] . Although SQD was previously shown to be associated with higher pathologic staging and increased risk of local recurrence, when accounting for stage, SQD does not alter overall survival (OS) or disease-specific survival (DSS) 7,8,[11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

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Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?

et al. 2015

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?

et al. 2015

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“…Pure non-TCCs are associated with more aggressive behavior, resulting in higher tumor stage at presentation and worse survival outcomes. 68,69 Less is known about the significance of TCCs with mixed histological features. 68 Approximately 10% of TCCs contain foci of glandular morphology, and up to 60% of tumors exhibit focal squamous differentiation.…”

Section: Tumor Histologymentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

298

275

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Bladder cancer is the fourth most common cancer and ranks eighth as a cause of death from cancer among men in the United States. Although guidelines assist in treatment, the art of managing bladder cancer, such as the decision to use neoadjuvant chemotherapy and the timing of cystectomy, is still variable. Bladder cancer has a propensity to recur, and with recurrence, a significant number of cases progress, which makes the early detection of high-risk patients imperative. Advances in detection, surveillance, and treatment of bladder cancer are reviewed in this article.

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Eligibility and Radiologic Assessment in Adjuvant Clinical Trials in Bladder Cancer

et al. 2019

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To harmonize eligibility criteria and radiographic disease assessments in clinical trials of adjuvant therapy for muscle-invasive bladder cancer (MIBC).METHODS National experts in bladder cancer clinical trial research, including medical and urologic oncologists, radiologists, biostatisticians, and patient advocates, convened at a public workshop on November 28, 2017, to discuss eligibility, radiographic entry criteria, and assessment of disease recurrence in adjuvant clinical trials in patients with MIBC. RESULTSThe key workshop conclusions for adjuvant MIBC clinical trials included the following points: (1) patients with urothelial carcinoma with divergent histologic differentiation should be allowed to enroll; (2) neoadjuvant chemotherapy is defined as at least 3 cycles of neoadjuvant cisplatin-based combination chemotherapy; (3) patients with muscle-invasive, upper-tract urothelial carcinoma should be included in adjuvant trials of MIBC; (4) patients with severe renal insufficiency can enroll into trials using agents that are not renally excreted;(5) patients with microscopic surgical margins can be included; (6) patients should undergo a standard bilateral lymph node dissection prior to enrollment; (7) computed tomographic (CT) imaging should be performed within 4 weeks prior to enrollment. For patients with renal insufficiency who cannot undergo CT imaging with contrast, noncontrast chest CT and magnetic resonance imaging of the abdomen and pelvis with gadolinium should be done; (8) biopsy of indeterminate lesions to evaluate for malignant disease should be done when feasible; (9) a uniform approach to evaluate indeterminate radiographic lesions when biopsy is not feasible should be included in any trial design; (10) a uniform approach to determining the date of recurrence is important in interpreting adjuvant trial results; and (11) new high-grade, upper-tract primary tumors and new MIBC tumors should be considered recurrence events. CONCLUSIONS AND RELEVANCEA uniform approach to eligibility criteria, definitions of no evidence of disease, and definitions of disease recurrence may lead to more consistent interpretations of adjuvant trial results in MIBC.

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Urothelial Carcinoma with Divergent Histologic Differentiation (Mixed Histologic Features) Predicts the Presence of Locally Advanced Bladder Cancer When Detected at Transurethral Resection

Cited by 200 publications

References 23 publications

Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?

Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?

Bladder Cancer in 2010: How Far have We Come?

Eligibility and Radiologic Assessment in Adjuvant Clinical Trials in Bladder Cancer

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