Add like
Add dislike
Add to saved papers

Upstaging of nonurothelial histology in bladder cancer at the time of surgical treatment in the National Cancer Data Base.

Urologic Oncology 2017 January
PURPOSE: To determine patient and pathologic characteristics as well as outcomes for patients with clinically localized, nonurothelial histology bladder cancer.

MATERIALS AND METHODS: Using the National Cancer Data Base, we identified patients between 2000 and 2010 diagnosed with bladder cancer as their only malignancy undergoing definitive surgical management. Patients were characterized as urothelial (n = 13,442), squamous (n = 789), small cell (n = 124), adenocarcinoma (n = 789), or other histology (n = 499). Patient and pathologic characteristics were compared across histologic subtypes. We also evaluated for incidence of T and N upstaging. Survival analysis was performed using the Kaplan-Meier method. Multivariate survival analysis was performed to identify predictors of adverse overall survival.

RESULTS: Patients with nonurothelial histology were more likely to be African-American, treated at academic medical centers, and of younger age (all P<0.05). Among those with nonurothelial histology, 55.4% of patients presenting with clinical stage T1 or less had their tumor upstaged during definitive surgical treatment compared to 42.7% of those with urothelial carcinoma. Squamous histology incurred the highest upgrading rate of 61.8%. Five-year survival varied by subtype, with universally decreased survival for those upstaged. Among nonurothelial histology, overall 5-year survival was 32.4% (95% CI: 28.8%-36.2%) vs. 46.0% (95% CI: 42.3%-49.6%) for those upstaged and not upstaged, respectively. Neoadjuvant therapy is used infrequently in this population.

CONCLUSION: We present the largest survival analysis of various rare subtypes of bladder cancer to date. Patients with nonurothelial bladder cancer have significantly higher rate of upstaging at cystectomy and with this a worsened overall survival. Aggressive treatment should be strongly considered for nonurothelial cancers when identified.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app