Micropapillary bladder cancer A review of the University of Texas M. D. Anderson Cancer Center experience with 100 consecutive patients

• Published in: Cancer Vol. 110; no. 1; pp. 62 - 67
• Main Authors: Kamat, Ashish M., Dinney, Colin P. N., Gee, Jason R., Grossman, H. Barton, Siefker‐Radtke, Arlene O., Tamboli, Pheroze, Detry, Michelle A., Robinson, Tracy L., Pisters, Louis L.
• Format: Journal Article
• Language: English
• Published: New York, NY Wiley-Liss 01.07.2007
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Papillary - drug therapy; Carcinoma, Papillary - pathology; Carcinoma, Papillary - surgery; Carcinoma, Transitional Cell - drug therapy; Carcinoma, Transitional Cell - pathology; Carcinoma, Transitional Cell - surgery; Combined Modality Therapy; Cystectomy - methods; Female; Hospitals, University; Humans; Male; Medical sciences; Middle Aged; Neoadjuvant Therapy - methods; Neoplasm Staging; Nephrology. Urinary tract diseases; Retrospective Studies; Survival Analysis; Texas; Tumors; Tumors of the urinary system; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urinary tract. Prostate gland; United States; North America; Texas; America; Human; Urinary system disease; Micropapillary carcinoma; Urinary tract disease; Transitional cell carcinoma; Malignant tumor; Bladder cancer; Chemotherapy; Cystectomy; Cancerology; Treatment; University; Surgery; Bladder disease; micropapillary transitional cell carcinoma; Bibliographic review
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.22756

Micropapillary bladder carcinoma is a rare variant of urothelial carcinoma. To improve understanding of this disease, the authors performed a retrospective review of their experience. The authors reviewed the records of 100 consecutive patients with micropapillary bladder cancer who were evaluated at The University of Texas M. D. Anderson Cancer Center. The mean age of the patients was 64.7 years, with a male:female ratio of 10:1. The TNM stage of disease at the time of presentation was Ta in 5 patients, carcinoma in situ (CIS) in 4 patients, T1 in 35 patients, T2 in 26 patients, T3 in 7 patients, T4 in 6 patients; N+ in 9 patients, and M+ in 8 patients. Kaplan-Meier estimates of 5-year and 10-year overall survival (OS) rates were 51% and 24%, respectively. Bladder-sparing therapy with intravesical bacillus Calmette-Guerin therapy was attempted in 27 of 44 patients with nonmuscle-invasive disease; 67% (18 patients) developed disease progression (>or=cT2), including 22% who developed metastatic disease. Of 55 patients undergoing radical cystectomy for surgically resectable disease (<or=cT4a), 23 received neoadjuvant chemotherapy and 32 were treated with initial cystectomy, with no significant difference noted in stage distribution between the 2 groups. For the 23 patients treated with neoadjuvant chemotherapy, the median OS was 43.2 months with 32% of patients still alive at 5 years. For the 32 patients treated with initial cystectomy, the median survival had not been reached at the time of last follow-up, with 71% still alive at 5 years. Micropapillary bladder cancer is associated with a poor prognosis. Intravesical therapy appears to be ineffective in this disease and patients with surgically resectable disease should be offered early radical cystectomy.