Clinical Outcomes of Micropapillary Urothelial Carcinoma of the Bladder Treated With Radical Cystectomy.

BACKGROUND/AIM: This study examined the treatment outcomes of radical cystectomy (RC) for micropapillary subtype (MPS) bladder cancer treated at our hospital.

PATIENTS AND METHODS

Histopathological findings of RC specimens collected from 2003 to 2020 were evaluated. Recurrence-free survival (RFS) and overall survival (OS) after RC, as well as the efficacy of chemotherapy in cases of recurrence, were retrospectively assessed.

RESULTS

Of 202 patients who underwent RC, seven (3.4%) had MPS bladder cancer. All seven patients underwent immediate RC without neoadjuvant chemotherapy. The median patient age was 58 years (range=52-71 years), and all patients were male. After RC, median RFS was 14 months (range=6-115 months), and median OS was 31 months (range=18-115 months). The clinical tumor stage was cT1 or lower in two patients (28.5%), cT2 in two patients (28.5%), and cT3 or higher in three patients (42.8%). No preoperative lymph node metastasis was observed. The pathological tumor stage was pT1 or lower in one patient (14.2%), pT2 in one patient (14.2%), and pT3 or higher in five patients (71.4%). The pathological lymph node stage was observed in five patients (71.4%). Although six of seven patients (85.7%) received adjuvant chemotherapy, all patients experienced relapse. The objective response rates of primary and secondary chemotherapy at relapse were both 33%. One patient received immune checkpoint inhibitor therapy and maintained stable disease for 12 months.

CONCLUSION

The recurrence rate after RC for MPS bladder cancer was high, and prognosis was poor.