Clinical outcomes of patients with squamous cell bladder cancer versus urothelial carcinoma with squamous differentiation after radical treatment
Katie
Hare1*,
Tom
Young1,
Rosalind
Kieran2,
Charlotte
Moss1,
Debra
H.
Josephs1,
Daisuke
Nonaka2,
Shamim
Khan2,
Rajesh
Nair2,
Ramesh
Thurairaja2,
Mieke
Van Hemelrijck1,
Simon
Hughes2 and
Deborah
Enting2
-
1
King's College London, United Kingdom
-
2
Guy's and St Thomas' NHS Foundation Trust, United Kingdom
Background
Squamous differentiation (SD) is found in up to 20% of urothelial carcinomas (UC) (1), with retrospective studies showing no clear prognostic difference compared with pure UC. Clinical significance of the extent of SD also remains unclear, with recent case series suggesting an association between extensive SD and worse clinical outcome (2). We evaluated clinical outcomes of patients with pure squamous cell carcinoma (SCC) of the bladder to UC with varying levels of SD.
Methods
We retrospectively studied patients with bladder SCC or UC with SD treated with radical treatment at Guy’s Hospital between 2011 and 2017. Demographic, treatment and clinical outcome data was collected. Patients were divided into three groups: pure SCC, UC with extensive SD (>50%) or focal SD (<50%).
Results
65 patients were identified: 45% (28/65) had pure SCC, 30% (20/65) UC with focal SD, 16% (11/65) UC with extensive SD and missing data on 9% (6/65) of cases. All patients with pure SCC underwent primary radical cystectomy. Neoadjuvant chemotherapy was more frequently given in patients with focal SD compared to extensive SD (50% vs 36%). Patients with extensive SD underwent cystectomy rather than radiotherapy in 82% versus 75% in the focal SD cohort. Patients with UC experienced disease relapses in 55% (17/31) compared to only 29% (8/28) of pure SCC patients, however no difference in disease relapse was observed between patients with focus versus extensive SD.
Conclusions
We found no evidence to suggest that more extensive SD correlates with worse clinical outcome, nor that SD carries better prognosis than bladder SCC. Further work is required to elucidate whether SD percentage carries clinical relevance.
References
1. Liu Y, Bui MM, Xu B. Urothelial Carcinoma With Squamous Differentiation Is Associated With High Tumor Stage and Pelvic Lymph-Node Metastasis. Cancer Control. 2017;24(1):78-82.
2. Slim M, Comperat E, Roupret M, Parra J, Simon J-M, Khayat D. Prognostic impact of percentage of squamous differentiation in patients with nonbilharzial squamous cell carcinoma and transitional cell carcinoma treated with radical cystectomy. Journal of Clinical Oncology. 2018;36(6):498
Keywords:
Bladder cancer,
Squamous differentiation,
Radical cystectomy,
Radical radiotherapy,
Recurrance
Conference:
Bladder Cancer Translational Research Meeting, London, United Kingdom, 29 Mar - 29 Mar, 2019.
Presentation Type:
Poster
Topic:
Elimination of uncertainty during surveillance following radical therapy
Citation:
Hare
K,
Young
T,
Kieran
R,
Moss
C,
Josephs
DH,
Nonaka
D,
Khan
S,
Nair
R,
Thurairaja
R,
Van Hemelrijck
M,
Hughes
S and
Enting
D
(2019). Clinical outcomes of patients with squamous cell bladder cancer versus urothelial carcinoma with squamous differentiation after radical treatment.
Front. Oncol.
Conference Abstract:
Bladder Cancer Translational Research Meeting.
doi: 10.3389/conf.fonc.2019.01.00012
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Received:
28 Feb 2019;
Published Online:
27 Sep 2019.
*
Correspondence:
Ms. Katie Hare, King's College London, London, United Kingdom, katie.hare@kcl.ac.uk