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Abstract
ObjectiveTo investigate the impact of squamous and/or glandular differentiation on recurrence and progression in patients with non-muscle-invasive urothelial carcinoma of bladder (NMIUCB) following transurethral resection (TURBT).MethodsA total of 869 patients with NMIUCB treated with TURBT at our institution from January 2006 to January 2011 were selected retrospectively for the analysis. Correlations among squamous and/or glandular differentiation with other clinical and pathological features were assessed by chi-square. Recurrence-free survival (RFS) and progression-free survival (PFS) curves were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were performed through a Cox proportional hazards regression model.ResultsAmong 869 consecutive patients, 232 (26.7%) patients had squamous and/or glandular differentiation. High grade tumors were more common in patients with squamous and/or glandular differentiation than those with pure UCB (P<0.001). Correlations between age (P=0.115), gender (P=0.184), tumor size (P=0.223), tumor multiplicity (P=0.108), pathological tumor stage (P=0.909) and squamous and/or glandular differentiation were not statistically significant. There was a statistically prominent tendency towards higher recurrence rate and shorter RFS time in patients with squamous and/or glandular differentiation. However, no statistically significant differences were observed in progression rate and PFS between the two groups. On multivariate Cox regression analysis, squamous and/or glandular differentiation was identified as an independent prognostic predictor of recurrence (HR 1.46, 95% CI, 1.10–1.92, P=0.008).ConclusionsThe presence of squamous and/or glandular differentiation could be associated with higher recurrence rate and shorter RFS time in patients with NMUCB. It is an independent prognostic predictor of recurrence.
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