Incidence and effect of variant histology on oncological outcomes in patients with bladder cancer treated with radical cystectomy

M Moschini, P Dell'Oglio, R Lucianò, G Gandaglia, Francesco Soria, Agostino Mattei, T Klatte, Rocco Damiano, SF Shariat, A Salonia, F Montorsi, A Briganti, R Colombo, Andrea Gallina

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: We sought to describe incidence of histological variants after radical cystectomy (RC) due to bladder cancer (BCa). Moreover, we investigated survival outcomes accounting for this parameter. METHODS: We retrospectively evaluated data from 1,067 patients with BCa treated with RC between 1990 and 2013 at a single tertiary care referral center. All specimen were evaluated by dedicated uropathologists. Univariable and multivariable Cox regression analyses tested the effect of different histopathological variant on recurrence, cancer-specific mortality (CSM), and overall mortality (OM) after accounting for all available confounders. RESULTS: Of 1,067 patients, 729 (68.3%) harbored pure urothelial BCa while 338 (31.7%) were found to have a variant. Considering uncommon variants, 21 (2.0%) were sarcomatoid, 10 (0.9%) lymphoepitelial, 19 (1.8%) small cell, 109 (10.2%) squamous, 89 (8.3%) micropapillary, 23 (2.2%) glandular, 34 (3.2%) mixed variants, and 33 (3.1%) were found with other types of variants. With a median follow-up of 6.2 years, 343 recurrence, 365 CSM, and 451 OM were recorded, respectively. At multivariable Cox regression analyses, the presence of small cell variant was associated with higher recurrence (hazard ratio [HR] = 3.47, P 0.1). CONCLUSION: Our study confirms that histological variant is not an infrequent event at RC specimen. However, in our single-center series, only patients found with small cell variant were associated with a negative effect on survival after RC. Copyright © 2017 Elsevier Inc. All rights reserved.
Original languageEnglish
Pages (from-to)335-341
Number of pages7
JournalUrologic Oncology
Volume35
Issue number6
DOIs
Publication statusPublished - 2017

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