- No difference in response to induction chemoradiation between pure (PUC) and variant (VUC) urothelial carcinoma.
Why this matters
- Largest study to date describing the response of VUC to trimodality bladder-sparing therapy (TMT).
- 250 (83%) patients had complete response to induction chemoradiation.
- No difference in rates of response between PUC and VUC (83% vs 82%; P=.9).
- No patient required radical cystectomy for treatment-related toxicity.
- 1-y, 5-y, and 10-y salvage cystectomy rates were 10%, 19%, and 24%, respectively in PUC vs 15%, 28%, and 28%, respectively in VUC (P=.3).
- 5-y and 10-y cumulative disease-specific survival (DSS) were 75% and 67% in PUC, vs 64% each in VUC (P=.4).
- 5-y and 10-y OS were 61% and 42%, vs 52% and 42% (P=.2).
- Bladder-intact DSS was not significantly different between VUC and PUC (P=.3).
- In a multivariable model, VUC was not associated with survival.
- Age, stage, hydronephrosis, and response to induction chemoradiation were significant predictors of OS.
- Hydronephrosis and incomplete response to induction therapy were associated with worse DSS.
- Retrospective study of 303 patients treated with TMT between 1993 and 2013.
- Funding: None.
- Single institution experience.
- Small sample sizes.
- Limited to transurethral resection of the bladder tumor specimens.