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. 2022 Sep-Oct;36(5):2365-2370.
doi: 10.21873/invivo.12968.

Squamous or Glandular Differentiation Predicts Poor Prognosis in pT1 Urothelial Carcinoma

Ryunosuke Nakagawa  1 , Hiroaki Iwamoto  2 , Tomoyuki Makino  3 , Suguru Kadomoto  1 , Hiroshi Yaegashi  1 , Kazuyoshi Shigehara  1 , Kouji Izumi  1 , Yoshifumi Kadono  1 , Atsushi Mizokami  1
Affiliations

Squamous or Glandular Differentiation Predicts Poor Prognosis in pT1 Urothelial Carcinoma

Ryunosuke Nakagawa et al. In Vivo. 2022 Sep-Oct.

Abstract

Background: The aim of this study was to evaluate the prognosis of patients with T1N0M0 urothelial carcinoma with squamous differentiation (UCSD) or glandular differentiation (UCGD) because it has not been determined whether these variant histologies behave more aggressively than pure urothelial carcinoma (PUC).

Patients and methods: Ninety-nine patients diagnosed with pT1N0M0 bladder cancer and treated conservatively with transurethral resection of bladder tumor at Kanazawa University Hospital between 2007 and 2019 were included in this study. The overall survival, cancer-specific survival (CSS), and recurrence-free survival of the variant histology and PUC groups were evaluated and compared.

Results: The variant histology group had significantly lower overall survival (p=0.006) and CSS (p=0.0095) than the PUC group did. Variant histology was found to be an independent prognostic factor in univariate and multivariate analyses for overall survival and CSS. On the other hand, no significant difference in progression-free survival was observed between the two groups (p=0.439). However, the variant histology group had significantly lower overall survival (p=0.004) and CSS (p=0.004) after progression.

Conclusion: The prognosis for patients with pT1 bladder cancer with UCSD or UCGD treated conservatively with transurethral resection of bladder tumor was poor. Considering the worse prognosis of these patients after stage progression, early radical cystectomy could be recommended.

Keywords: Urothelial carcinoma; glandular differentiation; non-muscle-invasive bladder cancer; squamous differentiation.

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Conflict of interest statement

All Authors declare that there are no potential conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1. Kaplan-Meier curve for overall (A), cancer-specific (B) and progression-free (C) survival of patients according to type of carcinoma, pure urothelial carcinoma (PUC) or variant histology (VH). CI: Confidence interval; HR: hazard ratio.
Figure 2
Figure 2. Kaplan-Meier curve for overall (A) and cancer-specific (B) survival of patients after clinical stage progression of their disease according to type of carcinoma, pure urothelial carcinoma (PUC) or variant histology (VH). CI: Confidence interval; HR: hazard ratio.
See this image and copyright information in PMC

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