A study aimed to assess the course and management of poorly differentiated bladder urothelial carcinoma (UC), including plasmacytoid UC (PUC), a rare and aggressive subtype with a poor prognosis that is still not well understood. The findings were reported in BJUI Compass.
In this retrospective analysis, researchers assessed all 37 cases of poorly differentiated high-grade UC over the last 15 years (2005-2020) in the Hunter New England area, with PUC variants compared with remaining poorly differentiated UC. The researchers noted that, of the included cases, 8 were PUC, 9 squamous variant, 2 neuroendocrine, and 1 sarcomatoid. Overall, 23 cases proceeded to cystectomy, 15 had chemotherapy (6 neoadjuvant), and 11 had radiation therapy.
Upon follow-up, the researchers observed that the PUC group had a cause-specific mortality of 50% with a mean survival of 202 days compared with 37.9% cause-specific mortality with a mean survival of 671.55 days (p =.23) in all other undifferentiated UC cases. Five-year cause-specific mortality rates were estimated at 26% and 59%, respectively (p =.058), with Kaplan-Meier analysis, the researchers noted.
“Poorly differentiated UC is demonstrated to have a poor prognosis with a high mortality rate, particularly when PUC is present. Given the rarity of these variants, further studies are necessary to explore the impact of current treatment options,” the researchers concluded.
Keywords: Epidemiology, Plasmacytoid urothelial carcinoma, Urinary bladder neoplasms, Urologic surgery