title: Do pure squamous cell carcinomas and urothelial carcinomas have similar prognosis after radical cystectomy?
abstract: OBJECTIVE
  The purpose of this study was to evaluate the surgical treatment results of urothelial carcinoma (UC) and pure squamous cell carcinoma of the bladder (SCC).
  
  
  METHODS
  The records of 460 patients who have undergone radical cystectomy in our department between the years 1991 and 2011 were analyzed retrospectively, and 364 patients with UC and 60 patients with pure SCC were evaluated.
  
  
  RESULTS
  Average ages of the patients with UC and SCC were 61.12 ± 8.9 and 59.38 ± 8.6 years, respectively (p = 0.902). UC group had 29 female patients, whereas SCC group had 9 female patients (p = 0.077). The mean follow-up periods were 26.09 ± 24.75 months for UC group and 22.23 ± 31.01 months for SCC group (p = 0.805). The incidence of organ-confined, extravesical, lymph node-positive diseases in UC and SCC cases was 48.9 and 32.2, 29.3 and 32.2 %, 21.8 and 35.6 %, respectively (p = 0.028). Five-year disease-specific survival (DSS) rates were 57.5 % in UC and 39.1 % in SCC group (p = 0.011). Five-year DSS rates were 81.2 % in UC and 75.0 % in SCC group in organ-confined disease (p = 0.534) and 28.2 % in UC and 40.9 % in SCC group in extravesical disease (p = 0.845). In lymph node-positive patients, DSS time was 20.9 ± 2.85 months in UC and 12.8 ± 2.07 months in SCC patients (p = 0.182). In multivariate analysis, pT stage (HR: 2.221; 95 % CI: 1.695-2.911) and lymph node involvement (HR: 2.863; 95 % CI: 1.819-4.509) were independently associated with DSS (p < 0.001), but histological subtype (HR: 1.423; 95 % CI: 0.798-2.538) was not a statistically significant factor (p = 0.232).
  
  
  CONCLUSIONS
  Although pure SCC cases are diagnosed at advanced stages of the disease, UC and pure SCC cases have similar prognosis by stages. Lymph node involvement and stages are the most important prognostic factors after radical cystectomy.
authors.affiliation: Ataturk Training and Research Hospital, Urology Clinic Basın Sitesi, 35360, Izmir, Turkey, ubalci1907@yahoo.com.
authors.forename: Ugur
authors.initials: U
authors.lastname: Balci
authors.forename: Kutan
authors.initials: K
authors.lastname: Ozer
authors.forename: Sacit Nuri
authors.initials: SN
authors.lastname: Gorgel
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Sefik
authors.forename: Cengiz
authors.initials: C
authors.lastname: Girgin
authors.forename: Cetin
authors.initials: C
authors.lastname: Dincel
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*