Objective
To evaluate oncological outcomes after radical cystectomy (RC) in patients with plasmacytoid
urothelial carcinoma (UC) and to compare survival to that in patients with pure UC
of the bladder.
Materials and Methods
We identified 46 patients with plasmacytoid UC and 972 with pure UC who were treated
with RC between 1980 and 2009. All pathologic specimens were re-reviewed by a single
GU pathologist. Patients were matched 1:2 by age, gender, Eastern Cooperative Oncology
Group performance status, pathologic tumor stage, and nodal status to patients with
pure UC. Survival was estimated using the Kaplan-Meier method and compared with the
log rank test.
Results
Patients with plasmacytoid UC were more likely to have extravesical disease (≥pT3)
(83% vs 43%, P < .0001) and positive margins (31% vs 2.1%, P < .0001) than patients with pure UC. Plasmacytoid UC was associated with decreased
overall survival (27% vs 45% at 5 years, relative risk [RR] 1.4, P = .04), cancer-specific survival (36% vs 57% at 5 years, RR 1.7, P = .01), and local recurrence-free survival (63% vs 81% at 5 years, RR 2, P = .01). When patients with plasmacytoid UC were matched to those with pure UC, there
were no significant differences in 5-year overall, cancer-specific, and local or distant
recurrence-free survival.
Conclusion
Plasmacytoid UC is associated with a high rate of locally advanced disease and positive
margins at RC, as well as increased local recurrence rates. Further research is necessary
to delineate adjuvant or neoadjuvant treatment strategies to improve local cancer
control of this rare subtype of UC.
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Article info
Publication history
Published online: November 16, 2016
Accepted:
September 3,
2016
Received:
June 20,
2016
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
