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- W2134927358 abstract "No AccessJournal of UrologyAdult Urology1 Jan 2012Comparative Outcomes of Pure Squamous Cell Carcinoma and Urothelial Carcinoma With Squamous Differentiation in Patients Treated With Radical Cystectomy Behfar Ehdaie, Alexandra Maschino, Shahrokh F. Shariat, Jorge Rioja, Robert J. Hamilton, William T. Lowrance, Stephen A. Poon, Hikmat A. Al-Ahmadie, and Harry W. Herr Behfar EhdaieBehfar Ehdaie Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , Alexandra MaschinoAlexandra Maschino Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat Departments of Urology and Medical Oncology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York More articles by this author , Jorge RiojaJorge Rioja Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , Robert J. HamiltonRobert J. Hamilton Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , William T. LowranceWilliam T. Lowrance Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , Stephen A. PoonStephen A. Poon Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , Hikmat A. Al-AhmadieHikmat A. Al-Ahmadie Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , and Harry W. HerrHarry W. Herr Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.09.056AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared clinical outcomes, and identified predictors of cancer specific and overall survival after radical cystectomy in patients with urothelial carcinoma with squamous differentiation and those with pure squamous cell carcinoma. Materials and Methods: We reviewed data on 2,031 patients treated with radical cystectomy and pelvic lymph node dissection at a single high volume referral center. Of these patients 78 had squamous cell carcinoma and 67 had squamous differentiation. Survival estimates by histological subtype were described using Kaplan-Meier methods. Within histological subtypes pathological stage, nodal invasion, soft tissue margins, age and gender were evaluated as predictors of cancer specific survival and overall survival using univariate Cox regression. Results: Median followup was 44 months. Of 104 patient deaths 60 died of their disease. We did not find a statistically significant difference between survival curves of patients with squamous cell carcinoma and squamous differentiation (log rank overall survival p = 0.6, cancer specific survival p = 0.17). Positive soft tissue margins were associated with worse cancer specific survival (HR 6.92, 95% CI 2.98–16.10, p ≤0.0005) and overall survival (HR 3.68, 95% CI 1.84–7.35, p ≤0.0005) in patients with pure squamous cell carcinoma. Among patients with squamous differentiation, pelvic lymphadenopathy was associated with decreased overall survival (HR 2.52, 95% CI 1.33–4.77, p = 0.004) and cancer specific survival (HR 3.23, 95% CI 1.57–6.67, p = 0.002). Conclusions: There appears to be no evidence of a difference in cancer specific survival or overall survival between patients with squamous cell carcinoma and those with squamous differentiation treated with radical cystectomy and pelvic lymph node dissection. Patients with squamous differentiation and tumor metastases to pelvic lymph nodes should be followed more closely, and adjuvant treatment should be considered to improve survival. Wide surgical resection is critical to achieve local tumor control and improve survival in patients with squamous cell carcinoma. References 1 : Global cancer statistics. CA Cancer J Clin2011; 61: 69. Google Scholar 2 : Clinical outcomes following radical cystectomy for primary nontransitional cell carcinoma of the bladder compared to transitional cell carcinoma of the bladder. J Urol2006; 175: 2048. 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Link, Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKim S, Frank I, Cheville J, Thompson R, Weight C, Thapa P and Boorjian S (2012) The Impact of Squamous and Glandular Differentiation on Survival After Radical Cystectomy for Urothelial CarcinomaJournal of Urology, VOL. 188, NO. 2, (405-409), Online publication date: 1-Aug-2012.Rink M, Robinson B, Green D, Cha E, Hansen J, Comploj E, Margulis V, Raman J, Ng C, Remzi M, Bensalah K, Kabbani W, Haitel A, Rioux-Leclercq N, Guo C, Chun F, Kikuchi E, Kassouf W, Sircar K, Sun M, Sonpavde G, Lotan Y, Pycha A, Karakiewicz P, Scherr D and Shariat S (2012) Impact of Histological Variants on Clinical Outcomes of Patients with Upper Urinary Tract Urothelial CarcinomaJournal of Urology, VOL. 188, NO. 2, (398-404), Online publication date: 1-Aug-2012. Volume 187Issue 1January 2012Page: 74-79 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordshistologycarcinomaurinary bladder neoplasmstreatment outcomesquamous cellcystectomyMetricsAuthor Information Behfar Ehdaie Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Alexandra Maschino Health Outcomes Research Group, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Shahrokh F. Shariat Departments of Urology and Medical Oncology, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York More articles by this author Jorge Rioja Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Robert J. Hamilton Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author William T. Lowrance Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Stephen A. Poon Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Hikmat A. Al-Ahmadie Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Harry W. Herr Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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