Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?

dc.contributor.authorYang, David Y.
dc.contributor.authorMonn, M. Francesca
dc.contributor.authorKaimakliotis, Hristos Z.
dc.contributor.authorCho, Jane S.
dc.contributor.authorCary, K. Clint
dc.contributor.authorPedrosa, Jose A.
dc.contributor.authorBihrle, Richard
dc.contributor.authorCheng, Liang
dc.contributor.authorKoch, Michael O.
dc.contributor.departmentDepartment of Urology, IU School of Medicineen_US
dc.date.accessioned2016-06-09T19:57:45Z
dc.date.available2016-06-09T19:57:45Z
dc.date.issued2015-11
dc.description.abstractIntroduction Interest on the impact of variant histology in bladder cancer prognosis is increasing. Although squamous differentiation is the most well characterized, only recently have less common variants gained increased recognition. We assessed whether squamous differentiation conferred a worse prognosis than nonvariant urothelial bladder cancer in a contemporary cohort of patients treated with radical cystectomy given the increased awareness of other less common variants. Methods We identified patients with squamous differentiation or nonvariant histology on transurethral resection of bladder tumor and/or cystectomy pathology during a 10-year period. Disease specific and overall survival were evaluated using Kaplan-Meier methodology. Cox regression was used to assess variables associated with mortality. Results Between 2003 and 2013, 934 patients underwent cystectomy for urothelial bladder cancer. Overall 617 nonvariant and 118 squamous differentiation cases were identified, and the remainder was nonsquamous differentiation variant histology. Overall 75% of patients with squamous differentiation had muscle invasive disease at diagnosis compared with 59% of those with nonvariant histology (p=0.002). Nonorgan confined disease at cystectomy was more common in patients with squamous differentiation (57% vs 44%, p=0.009). Among cases on neoadjuvant chemotherapy 20% (9 of 45) of nonvariant and 13% (1 of 8) of squamous differentiation were pT0N0 (p=0.527). Median followup was 52 months. Adjusted for demographics, pathological stage and chemotherapy, squamous differentiation was not associated with an increased risk of disease specific (HR 1.35, 95% CI 0.90–2.04, p=0.150) or all cause mortality (HR 0.90, 95% CI 0.60–1.25, p=0.515). Conclusions In a contemporary cohort of urothelial bladder cancer with recognition and characterization of less commonly described variants, squamous differentiation is not associated with a worse disease specific and all cause mortality when compared to a pure nonvariant cohort.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationYang, D. Y., Monn, M. F., Kaimakliotis, H. Z., Cho, J. S., Cary, K. C., Pedrosa, J. A., … Koch, M. O. (2015). Does Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer? Urology Practice, 2(6), 335–342. http://doi.org/10.1016/j.urpr.2015.02.003en_US
dc.identifier.urihttps://hdl.handle.net/1805/9868
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.isversionof10.1016/j.urpr.2015.02.003en_US
dc.relation.journalUrology Practiceen_US
dc.rightsPublisher Policyen_US
dc.sourceAuthoren_US
dc.subjecturinary bladder neoplasmsen_US
dc.subjectcarcinomaen_US
dc.subjecttransitional cellen_US
dc.titleDoes Squamous Differentiation Portend Worse Outcomes in Urothelial Bladder Cancer?en_US
dc.typeArticleen_US
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