title: Impact of histological variants on the outcomes of nonmuscle invasive bladder cancer after transurethral resection.
abstract: OBJECTIVE
  The scoring system used after transurethral resection of the bladder (TURB) to guide clinical decision-making regarding nonmuscle invasive bladder cancer (NMIBC) largely assumes that NMIBCs are pure urothelial carcinomas and does not take into account the role of variant histology. This review outlines pathological and clinical characteristics of major histological variants to determine their potential impact in therapeutic strategies for the management of NMIBC.
  
  
  RESULTS
  Assessing the presence of histological variants in NMIBCs after TURB currently remains challenging because of limited tissue sample sizes. However, the presence of these variants often indicates poor prognosis with increased risk for recurrence and progression. Among them, only the following histological variants are indications for Bacillus Calmette-Guerin intravesical instillations: squamous or glandular differentiations and deceptively benign or lymphoepithelioma-like carcinomas. However, patients diagnosed with any other variants should be promptly considered for early radical cystectomy, and only those with small cell carcinoma might benefit from neoadjuvant chemotherapy with a neuroendocrine-specific regimen.
  
  
  CONCLUSIONS
  Based on the available literature (e.g., small case studies and retrospective studies), the existence of histological variants after TURB appears to massively impact NMIBC outcomes.
authors: aAcademic Department of Urology, La Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris; Faculté de Médecine Pierre et Marie Curie, Université Paris 6 bUniversity of Paris cAcademic Department of Pathology, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Université Paris 6, Paris, France.
authors: Thomas
authors: T
authors: Seisen
authors: Eva
authors: E
authors: Compérat
authors: Priscilla
authors: P
authors: Léon
authors: Morgan
authors: M
authors: Roupret
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000283:Administration, Intravesical; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D004358:Drug Therapy; D006801:Humans; D009163:Mycobacterium bovis; D011379:Prognosis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*