MP34-19 EFFECT OF HISTOLOGICAL VARIANTS ON THE OUTCOMES OF RADICAL CYSTECTOMY FOR NON-METASTATIC MUSCLE-INVASIVE URINARY BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2017MP34-19 EFFECT OF HISTOLOGICAL VARIANTS ON THE OUTCOMES OF RADICAL CYSTECTOMY FOR NON-METASTATIC MUSCLE-INVASIVE URINARY BLADDER CANCER Malte W. Vetterlein, Thomas Seisen, Jeffrey J. Leow, Mark A. Preston, Maxine Sun, David F. Friedlander, Christian P. Meyer, Felix K.-H. Chun, Stuart R. Lipsitz, Mani Menon, Adam S. Kibel, Joaquim Bellmunt, Toni K. Choueiri, and Quoc-Dien Trinh Malte W. VetterleinMalte W. Vetterlein More articles by this author , Thomas SeisenThomas Seisen More articles by this author , Jeffrey J. LeowJeffrey J. Leow More articles by this author , Mark A. PrestonMark A. Preston More articles by this author , Maxine SunMaxine Sun More articles by this author , David F. FriedlanderDavid F. Friedlander More articles by this author , Christian P. MeyerChristian P. Meyer More articles by this author , Felix K.-H. ChunFelix K.-H. Chun More articles by this author , Stuart R. LipsitzStuart R. Lipsitz More articles by this author , Mani MenonMani Menon More articles by this author , Adam S. KibelAdam S. Kibel More articles by this author , Joaquim BellmuntJoaquim Bellmunt More articles by this author , Toni K. ChoueiriToni K. Choueiri More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1036AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Knowledge of comparative oncological outcomes of histological variants after radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) relies on small case series. Our aim was to compare the effect of squamous cell, adenocarcinoma, and neuroendocrine carcinoma vs. pure urothelial carcinoma of the bladder (UCB) on overall survival (OS) and pathological tumor, lymph node, and surgical margin status after RC. METHODS Using the National Cancer Data Base, we retrospectively examined patients undergoing RC for MIBC between 2003-2011. Our cohort was stratified according to pure histology: squamous cell, adenocarcinoma, neuroendocrine, and UCB. Inverse probability weighting (IPW)-adjusted and facility-clustered Cox and logistic regressions were used to assess the impact of histological variants vs. UCB on OS and histopathological outcomes. RESULTS Overall, 475 (4.4%), 224 (2.1%), 155 (1.4%), and 10,033 (92.2%) patients underwent RC for MIBC with pure squamous cell, adenocarcinoma, neuroendocrine carcinoma, and UCB, respectively. In IPW-adjusted analyses, squamous cell (HR=1.26; 95%CI=[1.07-1.49]; P=0.006) and neuroendocrine (HR=1.53; 95%CI=[1.21-1.95]; P<0.001) were associated with worse OS relative to UCB (Figure 1). Squamous cell (OR=1.58; 95%CI=[1.23-2.04]; P<0.001), adenocarcinoma (OR=1.49; 95%CI=[1.04-2.14]; P=0.030), and neuroendocrine carcinoma (OR=2.37; 95%CI=[1.58-3.55]; P<0.001) at diagnosis were associated with greater odds of ≥pT3 disease. Squamous and neuroendocrine variants were associated with decreased (OR=0.66; 95%CI=[0.48-0.91]; P=0.012) and increased (OR=1.58; 95%CI=[1.06-2.37]; P=0.026) odds of pN+ disease, respectively, while adenocarcinoma was associated with greater odds of positive margins (OR=2.14; 95%CI=[1.39-3.30]; P=0.001). CONCLUSIONS Pure squamous cell and neuroendocrine carcinoma is associated with worse OS relative to UCB, whereas no difference was found between adenocarcinoma and UCB. All histological variants were associated with higher pT stage at surgery compared to UCB. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e434-e435 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Malte W. Vetterlein More articles by this author Thomas Seisen More articles by this author Jeffrey J. Leow More articles by this author Mark A. Preston More articles by this author Maxine Sun More articles by this author David F. Friedlander More articles by this author Christian P. Meyer More articles by this author Felix K.-H. Chun More articles by this author Stuart R. Lipsitz More articles by this author Mani Menon More articles by this author Adam S. Kibel More articles by this author Joaquim Bellmunt More articles by this author Toni K. Choueiri More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...