1593 COMPARATIVE OUTCOMES OF PURE SQUAMOUS CELL CARCINOMA AND UROTHELIAL CARCINOMA WITH SQUAMOUS DIFFERENTIATION IN PATIENTS TREATED WITH RADICAL CYSTECTOMY (2011)

You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111593 COMPARATIVE OUTCOMES OF PURE SQUAMOUS CELL CARCINOMA AND UROTHELIAL CARCINOMA WITH SQUAMOUS DIFFERENTIATION IN PATIENTS TREATED WITH RADICAL CYSTECTOMY Behfar Ehdaie, Shahrokh F. Shariat, Alexandra C. Maschino, Jorge Riojo, Robert Hamilton, William T. Lowrance, Stephen Poon, Hikmat A. Al-Ahmadie, and Harry W. Herr Behfar EhdaieBehfar Ehdaie New York, NY More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat New York, NY More articles by this author , Alexandra C. MaschinoAlexandra C. Maschino New York, NY More articles by this author , Jorge RiojoJorge Riojo New York, NY More articles by this author , Robert HamiltonRobert Hamilton New York, NY More articles by this author , William T. LowranceWilliam T. Lowrance New York, NY More articles by this author , Stephen PoonStephen Poon New York, NY More articles by this author , Hikmat A. Al-AhmadieHikmat A. Al-Ahmadie New York, NY More articles by this author , and Harry W. HerrHarry W. Herr New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1643AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The prognostic value of squamous differentiation (SD) in patients with bladder urothelial carcinoma (UC) is uncertain. Similarly, conflicting evidence suggests that pure squamous cell carcinoma (SCC) bladder histology is associated with more advanced stage disease compared to pure UC. We sought to compare the effect of each of these histological variants on clinical outcomes of patients treated with radical cystectomy. METHODS We retrospectively reviewed 2506 patients treated with radical cystectomy and bilateral pelvic lymph node dissection at a single high-volume referral center. Pure SCC was present in the radical cystectomy specimen in 78 patients. SD was present in 67 patients. Cancer-specific (CSS) and overall survival estimates (OS) were described using Kaplan-Meier methods. Pathologic stage, vascular invasion, perineural invasion, surgical margins, concomitant carcinoma in situ (CIS), multicentricity, and neo-adjuvant chemotherapy were evaluated as predictors of cancer-specific and overall survival using univariate Cox regression studies. RESULTS The median follow-up for patients who were alive at last follow-up was 44 months. Overall, there were 104 deaths, 60 of which were cancer specific. At 4 years, patients with pure SCC and SD had a CSS probability of 42% (95%CI 28%, 55%) and 58% (95%CI 44%, 70%), respectively. OS and CSS among patients with pure SCC and SD was similar (OS: HR 1.10 (95%CI 0.75, 1.62) p=0.6; CSS HR 1.43 (95%CI 0.86, 2.38) p=0.17). On univariate analysis, positive surgical margins were significantly associated with increased risk of cancer-specific death and overall death in patients with pure SCC (both p<0.001). In patients with SD, pathologic stage (p=0.01) and vascular invasion (p=0.037) were significantly associated with an increased risk of overall death and pathologic stage (p=0.005) and neo-adjuvant chemotherapy (p=0.040) were associated with increased risk of cancer-specific death. CONCLUSIONS We did not see evidence that CSS and OS varied by squamous differentiation. Neo-adjuvant chemotherapy is associated with improved CSS in patients with SD. Pathologic stage predicts oncological outcomes in patients with SD; whereas surgical margins are associated with CSS and OS in patients with pure SCC. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e639 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Behfar Ehdaie New York, NY More articles by this author Shahrokh F. Shariat New York, NY More articles by this author Alexandra C. Maschino New York, NY More articles by this author Jorge Riojo New York, NY More articles by this author Robert Hamilton New York, NY More articles by this author William T. Lowrance New York, NY More articles by this author Stephen Poon New York, NY More articles by this author Hikmat A. Al-Ahmadie New York, NY More articles by this author Harry W. Herr New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...