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Thomas Flaig, MD
Thomas Flaig, MD
Posted: Wednesday, July 5, 2023
Based on a presentation given at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 4592), survival outcomes seem to differ between micropapillary and classic urothelial cancers of the bladder, with poorer results for those with the micropapillary subtype. However, for both subtypes of urothelial cancers, surgery in addition to perioperative chemotherapy was found to be associated with better survival. Additional efforts to evaluate the impact of novel therapeutic options are warranted to improve clinical outcomes in patients with these subtypes, suggested Rohan Garje, MD, of the Miami Cancer Institute, and colleagues.
From 2004 to 2019, 790 patients with classic urothelial carcinoma (n = 395) or micropapillary urothelial carcinoma (n = 395) were retrospectively reviewed. The sociodemographic, pathologic, and clinical attributes of patients were collected from the National Cancer Database. To adjust for baseline differences, propensity score matching was performed. Within both cohorts, 85% of cases were T2 (n = 334), 10% were T3 (n = 41), and 5% were T4 (n = 20). In addition, 95% of cases were N0 (n = 375), and 5% were N1 (n = 20).
The study findings revealed that patients with micropapillary urothelial carcinoma had a decreased survival rate compared with patients with classic urothelial carcinoma (hazard ratio [HR] = 1.26). Patients with an increased Charlson-Deyo Comorbidity Index and those aged 65 or older were also found to have a decreased survival rate. Furthermore, the addition of neoadjuvant chemotherapy to surgical intervention resulted in improved survival for patients (47.4 months for micropapillary, 78.0 months for classic) compared with surgical intervention alone (24.9 months for micropapillary, 56.2 months for classic, HR = 0.77). Moreover, patients who underwent surgery on the regional lymph nodes demonstrated an increased survival rate (HR = 0.59).
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
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