Login to Access Video or Poster Abstract: MP58-16
Sources of Funding: non

Introduction

To compare clinicopathological characteristics and oncologic outcomes between patients treated with radical cystectomy for pure squamous cell carcinoma (SCC) and urothelial carcinoma with squamous differentiation (SqD). We also, aimed to identify predictors of cancer specific survival (CSS) for each histologic variant.

Methods

We reviewed data of 1737 consecutive patients treated with radical cystectomy between January 2004 till February 2014. _x000D_ A total of 318 and 223 patients were diagnosed with SCC and SqD respectively. Squamous differentiation was defined as intercellular bridges or keratinization in the tumor._x000D_ Kaplan-Meier survival curves were used to estimate CSS._x000D_

Results

Patients’ demographics are illustrated in Table1. Patients with SqD were significantly more likely to have extravesical (58.3% vs 46.2%.p = 0.006) and nodal positive disease (34.5% vs 14.5%. p<0.0001) than SCC patients. Bilharzial eggs were found in 61% of SCC vs 46% of SqD (p=0.001)._x000D_ Median follow up period for SCC was 3.9 ( 0-12.4) versus 2 years (0-12) for SqD. During this period, 49 (15.4%) patients with SCC recurred locally and 20 (6.3%) recurred distally. Meanwhile, among SqD group 41 patients (18.4%) developed distant metastasis and 47 (21. 2%) experienced local recurrence. The estimated 5-year CSS was 77% and 59.8 % for SCC and SqD respectively (Fig.1) (Log rank <0.0001)._x000D_ _x000D_ In patients with SCC, Cox regression models identified higher T-stage (HR 2.3, 95% CI 1.3-3.9, P= 0.002) and preoperative anaemia (HR 1.7, 95% CI 1.035-2.8, P= 0.036) to be significantly associated with worse CSS. In patients with SqD, higher T-stage (HR 1.7, 95% CI 1.06-3, P= 0.028) and nodal metastasis (HR 2.2, 95% CI 1.3-3.5, P = 0.002) were associated with reduced CSS._x000D_

Conclusions

Patient with SCC had better 5-year CSS in comparison to SqD. The higher rate of extravesical disease and lymph node metastasis in SqD patients is indicative of aggressive behavior of this histologic type.

Funding

non