title: The nested variant of bladder transitional cell carcinoma: Review of 12 cases and review of the literature.
abstract: OBJECTIVE
  The nested variant of bladder transitional cell carcinoma is extremely rare and has a different biological behavior to other bladder tumors. The aim of this study is to analize if their behavior is as aggressive as has been described in the literature.
  
  
  METHODS
  Review of 12 diagnosed cases with nested variant of bladder transitional cell carcinoma and analysis of demographic characteristics, clinical presentation, tumor characteristics, treatment options, analysis of recurrence and cancer-specific survival between January 1997 and December 2010 in our hospital.
  
  
  RESULTS
  50% of the cases had a pathologic stage ≥T2, with grade of differentiation G2 (50%) or G3 (50%). After the pathological result of the TUR (transurethral resection) Bladder, 5 cases underwent radical cystoprostatectomy, 3 a second TUR bladder and 4 cases with treatment chemotherapy and/or radiotherapy (RT). Five out of 12 cases (41.7%) died due to bladder cancer and 3 died (25%) of other causes (urinary sepsis, respiratory failure, renal failure). With a median follow up of 40 months, the overall survival was 50% and cancer-specific survival of 65.6%.
  
  
  CONCLUSIONS
  The nested variant of bladder transitional cell carcinoma is a disease with an advanced-stage presentation, with high recurrence and mortality rates despite the use of different treatments. So far there is not a clinical practice guideline for this variety of urothelial tumor.
authors: Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: neilcebu@hotmail.com.
authors: C J
authors: CJ
authors: Carrion-Ballardo
authors: Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: L
authors: L
authors: Gala-Solana
authors: Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: J A
authors: JA
authors: Portillo-Martin
authors: Servicio de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: A
authors: A
authors: Azueta-Etxebarria
authors: Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: D
authors: D
authors: Truan-Cacho
authors: Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: F
authors: F
authors: Campos-Juanatey
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D015653:Cystectomy; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011468:Prostatectomy; D012907:Smoking / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery / Q000628:therapy
keywords: Bladder cancer survival; Bladder carcinoma; Carcinoma vesical; Supervivencia de cáncer vesical; Urothelial nested variant; Variedad urotelial en nidos