CLINICOPATHOLOGICAL AND PROGNOSTIC VALUE OF PLASMACYTOID SUBTYPE IN BLADDER CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS
Bladder cancer causes approximately 150,000 deaths per year and it is the second most prevalent genitourinary malignancy, after prostate adenocarcinoma. The most common histological type is the urothelial carcinoma, which accounts for approximately 90% of all bladder cancers¹. ¹. However, in 2004, the World Health Organization published a new classification that recognizes different histological variants (HV) of urothelial carcinomas ².Information on outcomes for patients with PUC histology is limited due to the rarity of the disease and the relative scarce publications. In this study, we performed a literature review and meta-analysis to explore the relationship between PUC and its prognostic value in bladder cancer.
MATERIALS AND METHODS
The PubMed database was searched systematically for relevant articles published up to April 30, 2018. Because the data in this study were extracted from previous studies, ethical approval from ethics committees was not required. The search terms used were ‘‘CARCINOMA and UROTHELIAL and PLASMACYTOID”.
There are important differences in the profiles of patients identified with pure urothelial carcinoma (UC) and plasmacytoid urothelial carcinoma (PUC). Only a small percentage of patients with bladder cancer are identified with the PUC variant (2%) and almost half are affected by the purest form of UC carcinoma (41%) (test t, t = -5.3, p = 0.005). There is no difference in the average age of those diagnosed, being approximately 65 years for both types. The proportion of female and male patients did not differ between UC and PUC, and higher among men (F = 904.2, p <0.001).
The presence of PUC is associated with locally advanced disease and positive lymph nodes compared with UC. Yet, PUC was not an independent predictor of long-term survival, so it is not an independent prognostic factor. The optimal treatment modality continues to be defined; neoadjuvant chemotherapy followed by radical cystectomy showed less rate of positive surgical margins.
Due to the low number of patients in the encompassed studies, we suggest a multicenter study to better understand this histological variant.
PPLASMMACYTOID CARCINOMA; histological variants; bladder cancer
Hospital Municipal dr. Mário Gatti - Sao Paulo - Brasil
Camila Rangel Travassos Burity, Ricardo Destro Saade, Fábio Thadeu Ferreira