Publication:
T1 bladder carcinoma with variant histology: pathological features and clinical significance.

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Date

2021-12-23

Authors

Lopez-Beltran, Antonio
Blanca, Ana
Cimadamore, Alessia
Montironi, Rodolfo
Luque, Rafael J
Volavšek, Metka
Cheng, Liang

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Springer
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Abstract

The aim of the study was to stratify high-grade T1 (HGT1) bladder urothelial carcinoma into risk categories based on the presence of variant histology when compared to conventional urothelial carcinoma. The clinicopathological features of 104 HGT1 cases of urothelial carcinoma of the bladder with variant histology present in 34 (37%) were assessed. The endpoint of the study was disease-free survival and cancer-specific survival. Overall, variant histology was identified as a significant predictor of disease-free survival (P = 0.035). The presence of any specific variant histology (squamous, glandular, micropapillary, nested, microcystic, inverted growth, villous-like, basaloid, and lymphoepithelioma-like) was identified as a significant predictor of disease-free survival (P = 0.008) and cancer-specific survival (P = 0.0001) in HGT1 bladder cancer. Therefore, our results support including micropapillary HGT1 urothelial carcinoma within the aggressive high-risk category, as suggested by some recent clinical guidelines, but also favor nested, glandular, and basaloid to be placed in the high-risk category due to their potential of aggressive, life-threatening behavior and their limited response to bacillus Calmette-Guerin therapy. Conversely, the low-risk category would include urothelial carcinomas with squamous, inverted growth, or microcystic morphology, all with limited life-threatening potential and good response to current therapy. A very low-risk category would finally include patients whose tumors present villous-like or lymphoepithelioma-like morphology. In conclusion, our findings support the value of reporting the variant histology as a feature of variable aggressiveness in HGT1 urothelial carcinoma of the bladder.

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MeSH Terms

Carcinoma, papillary
Carcinoma, squamous Cell
Carcinoma, transitional Cell
Female
Humans
Male
Urinary bladder
Urinary bladder neoplasms

DeCS Terms

Carcinoma papilar
Carcinoma de células escamosas
Carcinoma de células transicionales
Neoplasias de la vejiga
Vejiga urinaria

CIE Terms

Keywords

Biomarker, Bladder, Staging, T1 urothelial carcinoma, Variant histology

Citation

Lopez-Beltran A, Blanca A, Cimadamore A, Montironi R, Luque RJ, Volavšek M, et al. T1 bladder carcinoma with variant histology: pathological features and clinical significance. Virchows Arch. 2022 May;480(5):989-998