Re: The role of squamous differentiation in patients with transitional cell carcinoma of the bladder treated with radical cystectomy

LETTER TO THE EDITOR

Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil and Hospital Sirio Libanes, Sao Paulo, Brazil

Int Braz J Urol, 33: 339–346, 2007

To the Editor:

Antunes et al., provide an interesting insight into the adverse prognostic role of squamous differentiation of transitional cell carcinoma (TCC) of the bladder. In their retrospective study, both disease recurrence and mortality were statistically higher in those patients with squamous differentiation, with the adverse prognosis being confirmed on a multivariate analysis. Some deficiencies were noted in the study, most importantly the small number of patients, and the lack of information about the presence and extent of lymph node metastases, which may have affected results. Certainly these results have not been demonstrated by other investigators that have found no statistically significant difference between squamous differentiation and pure TCC, although many have shown mortality reductions with other subtypes such as adenocarinoma, carcinosarcoma and small cell carcinoma of the bladder (1–3). Nonetheless, it remains crucial that further, preferably randomized or well conducted retrospective studies are performed, to confirm which TCC subtypes truly portend a poorer prognosis. This data could then be used to assist in the integration of chemotherapy or radiotherapy, together with surgery in the management of these aggressive cancers in order to improve clinical outcomes.

References

1. Richie JP, Waisman J, Skinner DG, Dretler SP: Squamous carcinoma of the bladder: treatment by radical cystectomy. J Urol. 1976; 115: 670–2.

2. Ghoneim MA, el–Mekresh MM, el–Baz MA, el–Attar IA, Ashamallah A: Radical cystectomy for carcinoma of the bladder ; critical evaluation of results in 1026 cases J Urol. 1997; 158: 393–9.

3. Rogers CG, Palapattu GS, Shariat SF, Karakiewic PI, Bastian PJ, Lotan Y, et al.: Clinical outcomes following radical cystectomy for primary non transitional cell carcinoma of the bladder compared to transitional cell carcinoma of the bladder J Urol. 2006; 175: 2048–53.

Dr. Mark Frydenberg

Department of Urology

Monash Medical Centre, Monash University

Victoria, Australia

E–mail: [e-mail]

Re: The role of squamous differentiation in patients with transitional cell carcinoma of the bladder treated with radical cystectomy

Alberto A. Antunes; Luciano J. Nesrallah; Marcos F. Dall'Oglio; Carlos E. Maluf; Cesar Camara; Katia R. Leite; Miguel Srougi

Publication Dates

• Publication in this collection
  23 Oct 2007
• Date of issue
  Aug 2007