Puropse: To compare the clinical out comes after radical cystectomy between patients with urothelial (UC) and non-urothelial(non-UC) of the bladder.
Material and methods: Total of 432 patients underwent radical cystectomy with bilateral pelvic lymphadenectomy for bladder cancer at our department were enrolled. UC was present in the radical cystectomy specimen in 342 patients. Non-UC histology was present in 90 patients (21%), including squamous cell carcinoma in 56, adenocarcinoma in 8, undifferentiated cell carcinoma in 15, and other non-UC subtypes in 11 patients. Mean follow-up were 23.15+20.83 and 19.67+16.27 months for patients with UC and non-UC histologies, respectively. Bladder cancer specific survival was assessed using Kaplan-Meier and log-renk multivariate Cox regression tests.
Results: Five-year disease specific survival for patients with UC was 56.8% and 27.8% non-UC respectively(p=0.003). The lymph node involvement was significantly higher in patients with non-UC(39.75%) than in patients with UC(21.23%) of the bladder (p=0.001). The stages of the tumors in patients with non-UC were higher than that of patients with UC (p=0.001). Bladder cancer specific mortality did not differ significantly between patients with SCC and UC histologies (p=0.1). However patients with non-UC and non-SCC bladder cancer were at significantly increased risk for progression and death compared to patients with UC (p=0.001).
Conclusion: TCC and SCC seems to have similar survival rate. Patients with Non-UC and non-SCC histology have the worse prognosis.