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Objective: Bladder cancer is a heterogeneous entity characterized by a wide range of different morphologies. The aim of this study was to investigate the prognostic effect of bladder tumor with variant histology that is treated with radical cystectomy on oncological outcomes. Methods: One hundred eighty-six patients who underwent radical cystectomy between September 2001 and June 2020 were included in the study. The patients were divided into 2 groups variant histology group (n = 54) and transitional cell cancer group (n = 132). Clinicopathologic data were compared between the two groups. Results: The groups were similar in terms of demographic characteristics. In the multivariate analysis of cancer-specific survival in transitional cell cancer against variant histology, high-grade detection of primary transurethral bladder tumor pathology, cystectomy pT, cystectomy positive lymph node, and positive surgical margin in cystectomy were determined to be statistically significant. Diagnosis of pT2 and high grade of primary transurethral bladder tumor pathology, cystectomy ≥ pT3, cystectomy positive lymph node, and positive surgical margin in cystectomy were statistically significant in multivariate analysis of overall survival. Cancer-specific survival time was estimated at 65.1 ± 8.3 months for variant histology and 134.2 ± 10.4 months for transitional cell cancer (P = .004). The estimated overall survival time was 61.9 ± 8.0 months in variant histology and 119.0 ± 9.8 months in transitional cell cancer (P = .014). Conclusion: Pathological features and prognosis of bladder cancer with variant histologies are worse than those of pure urothelial bladder cancer. Overall survival and cancer-specific survival are shorter in bladder cancer with variant histology than in pure urothelial bladder cancer. Following the diagnosis of variant histology in transurethral bladder tumor, poor prognosis must be considered in the treatment plan. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the potential significance of the second transurethral resection of a bladder tumor (TURBT) in a population of patients whose primary pathology was high-grade pTa (Ta/HG) and who had received Bacillus Calmette-Guérin (BCG) treatment for at least 12 on oncological outcomes, based on the presence or absence of detrusor muscle. Materials and Methods: Patients with primary Ta/HG tumors (n=207) that met the inclusion criteria were grouped based on the presence of muscle tissue in the first TURBT and whether the secondary TURBT was performed. Progression, recurrence, and disease-free survival rates were compared between the groups. Results: Median follow-up period was 24 (12-205) months. In cases with muscle in the first TURBT, a second TURBT significantly increased the median disease-free survival time compared with those that did not undergo the second TURBT [32 months (12-83) vs 12 months (6-67); p<0.005]. In cases without muscle in the first TURBT, the second TURBT significantly reduced the rate of progression (p<0.05). Regression analysis showed that tumor size >3 cm [95% confidence interval (CI)=1.09-2.96, hazard ratio (HR)=1.79, p=0.021], presence of muscle tissue (95% CI=0.35-0.92, HR=0.57, p=0.022), and multiple tumor (95% CI=1.06-2.90, HR=1.75, p=0.028) were independent factors affecting disease relapse in primary Ta/HG tumor. Conclusions: In patients with primary Ta/HG tumors, if there was no muscle in the first TURBT, a second TURBT should be performed to achieve lower progression rates. If there is muscle in the first TURBT, the second TURBT will only increase the median disease-free survival time. [ABSTRACT FROM AUTHOR]

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Copyright of Turkish Journal of Urology is the property of Turkish Association of Urology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)