PD41-07 PROGNOSTIC SIGNIFICANCE OF LYMPHO-VASCULAR INVASION IN PATIENTS WITH SQUAMOUS CELL CARCINOMA IN COMPARISON TO UROTHELIAL CARCINOMA OF THE BLADDER

Abstract

You have accessJournal of UrologyBladder Cancer: Staging1 Apr 2015PD41-07 PROGNOSTIC SIGNIFICANCE OF LYMPHO-VASCULAR INVASION IN PATIENTS WITH SQUAMOUS CELL CARCINOMA IN COMPARISON TO UROTHELIAL CARCINOMA OF THE BLADDER Kyle Spradling, Hassan Abol-Enein, Ahmed Mosbah, Zhamshid Okhunov, Jaime Landman, Ahmed Shokeir, Mohamed Ghoneim, and Ramy Youssef Kyle SpradlingKyle Spradling More articles by this author , Hassan Abol-EneinHassan Abol-Enein More articles by this author , Ahmed MosbahAhmed Mosbah More articles by this author , Zhamshid OkhunovZhamshid Okhunov More articles by this author , Jaime LandmanJaime Landman More articles by this author , Ahmed ShokeirAhmed Shokeir More articles by this author , Mohamed GhoneimMohamed Ghoneim More articles by this author , and Ramy YoussefRamy Youssef More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2415AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lympho-vascular invasion (LVI) has been shown to be an independent predictor of oncological outcomes in patients with urothelial carcinoma of the bladder (UCB) but its prognostic significance has not been studied in squamous cell carcinoma (SCC) due to the relative rarity of the disease. Herein, we compare the prognostic significance of LVI between SCC and UCB. METHODS We performed a retrospective analysis of patients who underwent radical cystectomy (RC) for invasive bladder cancer at one institution between 1997 – 2003. A cohort of 879 patients with pure UCB or SCC of the bladder were included. The prognostic significance of LVI was compared between UCB and SCC in relation to disease-free survival (DFS) and cancer-specific survival (CSS) after RC using Kaplan-Meier analyses and multi-variable Cox-regression analyses. RESULTS The study included 519 patients (59%) with UCB and 360 (41%) with SCC. Median age was 55 years (range 20 – 87) and median follow-up was 44 months (0 – 108). LVI was found in 288 patients (32.8%) [47 (13.1%) SCC vs. 241 (46.4%) UCB; p <0.001]. Positive lymph node status (LN+) was found in 219 patients (25%) [66 (18.3%) vs. 153 (29.5%); p < 0.001]. LVI was found to be associated with DFS and CSS in both SCC and UCB groups. Furthermore, in node negative, LVI+ SCC patients (LVI+/LN-), DFS was similar to LN+ patients (Figure 1). In a multi-variable Cox regression analysis, LVI was found to be an independent predictor of oncologic outcomes with higher prognostic significance in SCC than UCB. In UCB, patients with LN+ disease had significantly higher risk of disease recurrence and cancer specific mortality in comparison to LVI+/LN- (HR 2.5 vs. 1.8; P < 0.001 and HR 2.5 vs. 1.5; P = 0.006, respectively). While in SCC, patients with LVI+/LN- had high risk of disease recurrence and cancer specific mortality comparable to LN+ patients (HR 2.8 vs. 2.5 and HR 3.7 vs. 2.0, respectively). CONCLUSIONS LVI is an independent predictor of oncologic outcomes in UCB and SCC, but has higher prognostic significance in SCC. To our knowledge, this is the first study to identify LVI as a high-risk adverse pathological feature in SCC of the bladder. Moreover, LVI+/LN- SCC patients showed poor oncological outcomes similar to LN+ patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e842-e843 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyle Spradling More articles by this author Hassan Abol-Enein More articles by this author Ahmed Mosbah More articles by this author Zhamshid Okhunov More articles by this author Jaime Landman More articles by this author Ahmed Shokeir More articles by this author Mohamed Ghoneim More articles by this author Ramy Youssef More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...