Non-transitional Cell Carcinoma of The Bladder: Single Center Experience

INTRODUCTION: Because non-transitional bladder cancers are rare, there is a few data in the literature. For this purpose, patients were evaluated retrospectively in terms of clinicopathologic characteristics, treatment modalities, and their prognostic effects.
METHODS: Thirty patients with pure non-urothelial bladder cancer, who were followed between October 2004 and September 2015, were evaluated retrospectively.
RESULTS: Out of 390 consecutive patients with bladder cancers, 30 had pure non-urothelial carcinoma (7.6%): %3.9 SqCC, %2.0 AC, %1.0 SmCC, %0.7 another non-urothelial carcinoma. The median age of the patients was 60 years (range, 22–82 years) and the male/female ratio was 4: 1 (24 males and 6 females). The most common symptom was macroscopic hematuria (73.3%). Seven patients (23.3%) had stage II disease, ten patients (33.3%) had stage III disease and thirteen patietns (43.3%) had stage IV disease. The median follow-up period was 10.0 months, during which 80.0% experienced recurrence/progression, and 76.7% died. The median overall survival (OS) was 10.0 months and there was no significant difference in terms of histopathological subtypes (P=0.30). The median OS of seventeen patients with stage 2-3 was 13.1 months. The median survival for stage I–III patients treated with surgery±CT ±RT (median OS yet not reached) was longer than for those treated with TUR ± CT ± RT (10 months) (P = 0.07). Univariate analysis revealed that younger age (P=0.04), stage 2-3 disease (P=0.02), ECOG performance status<2 (P=0.04), and the absence of metastasis (P=0.04) were factors indicating a good prognosis.
DISCUSSION AND CONCLUSION: In patients with non-urothelial cancer, there was no overall survival difference between groups in terms of histopathological subtypes. At the time of diagnosis, younger age, stage 23 disease, ECOG performance status<2, and the absence of metastasis were factors indicating a good prognosis. Surgery ± CT ± RT resulted in significantly better OS, except for in patients with stage 4 disease.

Mesanenin Transisyonel Hücreli Olmayan Kanserleri: Tek Merkez Deneyimi

GÝRÝÞ ve AMAÇ: Transisyonel hücreli olmayan mesane kanserleri nadir görüldüðü için literatürde daha az veri bulunmaktadýr. Bu amaçla hastalar klinikopatolojik özellikleri, tedavi modaliteleri ve bunlarýn prognoza etkileri açýsýndan retrospektif olarak deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: Ekim 2004-Eylül 2014 tarihleri arasýnda kliniðimizde püre transisyonel hücreli olmayan mesane kanseri tanýsý teyit edilen 30 hasta retrospektif olarak deðerlendirildi. Transisyonel kanser içeren miks tümörler çalýþma dýþý býrakýldý.
BULGULAR: Çalýþmamýzda mesane kanserli hastalarýn %7.6’sýnda transisyonel hücreli olmayan karsinom olup bunlarýn %3.9’u skuamöz hücreli karsinom (SHK), %2’si adenokarsinom, %1’i küçük hücreli karsinom (KHK) olup, %0.7’si diðer transisyonel hücreli olmayan kanser tipleri idi. Çalýþmaya dahil edilen 30 hastanýn taný anýnda ortanca yaþý 60 yýl (aralýk; 22-82), erkek/kadýn oraný 4: 1 (24 erkek, 6 kadýn) ve taný anýnda en sýk semptom makroskopik hematüri (%73.3) idi. 7 (%23.3) hastada evre 2, 10 (%33.3) hastada evre 3, 13 (%43.3) hastada ise evre 4 hastalýk saptandý. Ortanca takip süresi 10 ay olup hastalarýn %80.0’ninde nüks/progresyon, %76.7’sinde ölüm gerçekleþti. Hastalarýn ortanca saðkalýmý 10.0 ay olup, histopatolojik alt tipler açýsýndan anlamlý farklýlýk yok idi (P=0.30). Lenf nodu tutulumu ve uzak metastazý olan hastalar çalýþma dýþý býrakýldýðýnda erken evre mesane kanserli 17 hastanýn ortanca saðkalýmý 13.1 ay olup, tedavi modaliteleri açýsýndan deðerlendirildiðinde TUR±KT±RT uygulananlarda 10.0 ay iken, cerrahi±KT±RT uygulananlar ortanca saðkalýma ulaþmamýþtý (P=0.07). Taný anýnda ECOG performans durumunun 0-1 olmasý (P=0.04), 60 yaþ ve altýnda olmak (P=0.04), evre 2 ya da 3 hastalýða sahip olmak (P=0.02), uzak metastazýn olmamasý (P=0.04) ortanca sað kalýmý olumlu etkileyen faktörler idi.
TARTIÞMA ve SONUÇ: Transisyonel hücreli olmayan mesane kanserli hastalarda histopatolojik alt tiplere göre gruplar arasýnda genel saðkalým farký saptanmadý. Taný anýnda ECOG performans durumunun 0-1 olmasý, 60 yaþ ve altýnda olmak, evre 2 ya da 3 hastalýða sahip olmak, uzak metastazýn olmamasý ortanca saðkalýmý olumlu etkileyen faktörler idi. Evre 4 hastalýk dýþýndaki hastalarda cerrahi ± kemoterapi ve/veya radyoterapinin saðkalýmý anlamlý olarak artýrdýðý gözlendi.