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Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma

OBJECTIVES: The aim of this study is to assess the course and management of poorly differentiated bladder urothelial carcinoma (UC), including plasmacytoid UC (PUC), in our local area. Although bladder cancer is relatively common, PUC is a rare and aggressive subtype with a poor prognosis that is st...

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Autores principales: Lockhart, Kathleen, King, Simon, Grant, Alexander, McLeod, Nicholas, Tiu, Albert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988797/
https://www.ncbi.nlm.nih.gov/pubmed/35475149
http://dx.doi.org/10.1002/bco2.108
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author Lockhart, Kathleen
King, Simon
Grant, Alexander
McLeod, Nicholas
Tiu, Albert
author_facet Lockhart, Kathleen
King, Simon
Grant, Alexander
McLeod, Nicholas
Tiu, Albert
author_sort Lockhart, Kathleen
collection PubMed
description OBJECTIVES: The aim of this study is to assess the course and management of poorly differentiated bladder urothelial carcinoma (UC), including plasmacytoid UC (PUC), in our local area. Although bladder cancer is relatively common, PUC is a rare and aggressive subtype with a poor prognosis that is still poorly understood. MATERIALS AND METHODS: A retrospective assessment of all poorly differentiated high‐grade UC over the last 15 years (2005–2020) in the Hunter New England area was completed. In total, 37 patients were included, and PUC variant was compared with the remaining poorly differentiated UC. RESULTS: Of the included cases, eight were PUC, nine squamous variant, two neuroendocrine, and one sarcomatoid. Overall, 23 cases proceeded to cystectomy, 15 had chemotherapy (six neoadjuvant), and 11 had radiation therapy. In the PUC subgroup, three had metastatic disease at diagnosis (37.5%). Of the three PUC patients who underwent cystectomy, all were upstaged. Two PUC cases had adjuvant chemotherapy, and one case had radiation. Within the follow‐up period, the PUC group had a cause‐specific mortality of 50% with a mean survival in these patients of 202 days, compared with 37.9% cause‐specific mortality with survival of 671.55 days (p = 0.23) in all other undifferentiated UC cases; 5‐year cause‐specific mortality with Kaplan–Meier analysis was estimated at 26% compared with 59%, respectively (p = 0.058). CONCLUSION: Poorly differentiated UC is demonstrated to have a poor prognosis with a high mortality rate, particularly when PUC is present. Given the rarity of these variants, further studies are necessary to explore the impact of current treatment options.
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spelling pubmed-89887972022-04-25 Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma Lockhart, Kathleen King, Simon Grant, Alexander McLeod, Nicholas Tiu, Albert BJUI Compass Original Articles OBJECTIVES: The aim of this study is to assess the course and management of poorly differentiated bladder urothelial carcinoma (UC), including plasmacytoid UC (PUC), in our local area. Although bladder cancer is relatively common, PUC is a rare and aggressive subtype with a poor prognosis that is still poorly understood. MATERIALS AND METHODS: A retrospective assessment of all poorly differentiated high‐grade UC over the last 15 years (2005–2020) in the Hunter New England area was completed. In total, 37 patients were included, and PUC variant was compared with the remaining poorly differentiated UC. RESULTS: Of the included cases, eight were PUC, nine squamous variant, two neuroendocrine, and one sarcomatoid. Overall, 23 cases proceeded to cystectomy, 15 had chemotherapy (six neoadjuvant), and 11 had radiation therapy. In the PUC subgroup, three had metastatic disease at diagnosis (37.5%). Of the three PUC patients who underwent cystectomy, all were upstaged. Two PUC cases had adjuvant chemotherapy, and one case had radiation. Within the follow‐up period, the PUC group had a cause‐specific mortality of 50% with a mean survival in these patients of 202 days, compared with 37.9% cause‐specific mortality with survival of 671.55 days (p = 0.23) in all other undifferentiated UC cases; 5‐year cause‐specific mortality with Kaplan–Meier analysis was estimated at 26% compared with 59%, respectively (p = 0.058). CONCLUSION: Poorly differentiated UC is demonstrated to have a poor prognosis with a high mortality rate, particularly when PUC is present. Given the rarity of these variants, further studies are necessary to explore the impact of current treatment options. John Wiley and Sons Inc. 2021-08-27 /pmc/articles/PMC8988797/ /pubmed/35475149 http://dx.doi.org/10.1002/bco2.108 Text en © 2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Lockhart, Kathleen
King, Simon
Grant, Alexander
McLeod, Nicholas
Tiu, Albert
Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma
title Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma
title_full Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma
title_fullStr Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma
title_full_unstemmed Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma
title_short Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma
title_sort outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988797/
https://www.ncbi.nlm.nih.gov/pubmed/35475149
http://dx.doi.org/10.1002/bco2.108
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