Intravesical Therapy for Non-Muscle-Invasive Bladder Cancer: What Is the Real Impact of Squamous Cell Carcinoma Variant on Oncological Outcomes?

Guglielmo Mantica,Franco Gaboardi,Giovanni Guano,Rafaela Malinaric,Martina Beverini,Francesco Chierigo,Nazareno Suardi,Lorenzo Rigatti,Davide De Marchi,Salvatore Smelzo,Alessandro Tafuri,Carlo Terrone,Aldo Franco De Rose,Alberto Caviglia,Francesca Ambrosini

doi:10.3390/medicina58010090

Abstract

Background and Objectives: To evaluate the oncological impact of squamous cell carcinoma (SCC) variant in patients submitted to intravesical therapy for non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: Between January 2015 and January 2020, patients with conventional urothelial NMIBC (TCC) or urothelial NMIBC with SCC variant (TCC + SCC) and submitted to adjuvant intravesical therapies were collected. Kaplan–Meier analyses targeted disease recurrence and progression. Uni- and multivariable Cox regression analyses were used to test the role of SCC on disease recurrence and/or progression. Results: A total of 32 patients out of 353 had SCC at diagnosis. Recurrence was observed in 42% of TCC and 44% of TCC + SCC patients (p = 0.88), while progression was observed in 12% of both TCC and TCC + SCC patients (p = 0.78). At multivariable Cox regression analyses, the presence of SCC variant was not associated with higher rates of neither recurrence (p = 0.663) nor progression (p = 0.582). Conclusions: We presented data from the largest series on patients with TCC and concomitant SCC histological variant managed with intravesical therapy (BCG or MMC). No significant differences were found in term of recurrence and progression between TCC and TCC + SCC. Despite the limited sample size, this study paves the way for a possible implementation of the use of intravesical BCG and MMC in NMIBC with histological variants.

Highlights

Introduction iationsBladder cancer (BCa) is one of the most common malignancies, and it counts for about 165,000 deaths/year worldwide [1,2,3]
No significant differences in terms of mean age, smoking, pT1 stage, high grade, concomitant carcinoma in situ, dimensions, and single vs. multiple lesions were found between
We presented data from the largest series on patients with Transitional Cell Carcinoma (TCC) and concomitant

Summary

Introduction

Bladder cancer (BCa) is one of the most common malignancies, and it counts for about 165,000 deaths/year worldwide [1,2,3]. 75% of newly diagnosed BCas are non-muscle-invasive (NMIBC), which is a disease burdened by recurrence in more than. The most predominant histological phenotype is the conventional urothelial carcinoma/Transitional Cell Carcinoma (TCC), which constitutes about 80% of bladder cancer. Histological variants (HVs) [6,7] are present in up to 20% of patients, and the squamous cell carcinoma (SCC) variant in roughly 10% of patients [8]. The role of HVs in NMIBC has become of great interest over the last decade.

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