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

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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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Cystectomy
Urinary Bladder Neoplasms
Histology
Mortality
Incidence
Tertiary Care Centers
Recurrence
Regression Analysis
Survival
Neoplasms

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Incidence and effect of variant histology on oncological outcomes in patients with bladder cancer treated with radical cystectomy. / Moschini, M; Dell'Oglio, P; Lucianò, R; Gandaglia, G; Soria, Francesco; Mattei, Agostino; Klatte, T; Damiano, Rocco; Shariat, SF; Salonia, A; Montorsi, F; Briganti, A; Colombo, R; Gallina, Andrea.

In: Urologic Oncology, Vol. 35, No. 6, 2017, p. 335-341.

Research output: Contribution to journalArticle

Moschini, M, Dell'Oglio, P, Lucianò, R, Gandaglia, G, Soria, F, Mattei, A, Klatte, T, Damiano, R, Shariat, SF, Salonia, A, Montorsi, F, Briganti, A, Colombo, R & Gallina, A 2017, 'Incidence and effect of variant histology on oncological outcomes in patients with bladder cancer treated with radical cystectomy', Urologic Oncology, vol. 35, no. 6, pp. 335-341. https://doi.org/10.1016/j.urolonc.2016.12.006
Moschini, M ; Dell'Oglio, P ; Lucianò, R ; Gandaglia, G ; Soria, Francesco ; Mattei, Agostino ; Klatte, T ; Damiano, Rocco ; Shariat, SF ; Salonia, A ; Montorsi, F ; Briganti, A ; Colombo, R ; Gallina, Andrea. / Incidence and effect of variant histology on oncological outcomes in patients with bladder cancer treated with radical cystectomy. In: Urologic Oncology. 2017 ; Vol. 35, No. 6. pp. 335-341.
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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 {\circledC} 2017 Elsevier Inc. All rights reserved.",
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T1 - Incidence and effect of variant histology on oncological outcomes in patients with bladder cancer treated with radical cystectomy

AU - Moschini, M

AU - Dell'Oglio, P

AU - Lucianò, R

AU - Gandaglia, G

AU - Soria, Francesco

AU - Mattei, Agostino

AU - Klatte, T

AU - Damiano, Rocco

AU - Shariat, SF

AU - Salonia, A

AU - Montorsi, F

AU - Briganti, A

AU - Colombo, R

AU - Gallina, Andrea

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

U2 - 10.1016/j.urolonc.2016.12.006

DO - 10.1016/j.urolonc.2016.12.006

M3 - Article

VL - 35

SP - 335

EP - 341

JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

IS - 6

ER -