Signet Ring Cell Adenocarcinoma of Urinary Bladder: Clinicopathologic Features of Patients Undergoing Radical Cystectomy
Sreeharsha N Masineni, Stephen A Boorjian, Igor Frank, Prabin Thapa, John C Cheville. Mayo Clinic, Rochester, MN; Mayo Clnic, Rochester, MN
Background: Signet ring cell carcinoma (SRCC) is a rare subtype of urothelial carcinoma involving the urinary bladder that has been reported to have a worse prognosis than typical urothelial carcinoma (UC). However, few studies have examined the outcome of patients with SRCC treated by radical cystectomy (RC). In this study, we compared the clinical and pathologic features of a large series of patients of SRCC and UC treated by RC.
Design: A clinical and pathologic review of 3436 patients undergoing RC for bladder cancer at the Mayo Clinic between 1980 and 2011 identified 43 (1.3%) patients with SRCC. The pathologic and clinical features of SRCC and UC were compared including cancer-specific (CS) outcomes. In addition, a case-control analysis was performed where a patient with SRCC was matched with at least 3 patients with UC for age at surgery, year of surgery, TNM stage and ECOG status. Survival estimates were compared using Log rank test.
Results: There were 35 patients with SRCC that had adequate clinical follow-up. Patients with SRCC presented at a higher T stage (p<0.0001) and were more likely to receive perioperative and adjuvant chemotherapy than patients with UC (p<0.0001). Most patients (91%) with SRCC presented with pT3a or higher. Overall patients with SRCC had a worse 5-year CS survival than patients with UC (5-yr CS survival 34% vs 55%, respectively; p=0.04). However, in the case-control analysis, there was no difference in CS outcome between patients with SRCC and UC (5 yr CS survival 34% vs 31%, respectively; p=0.63).
Conclusions: Patients with SRCC treated surgically present at a higher tumor stage and are more likely to receive chemotherapy than patients with UC. Overall, patients with SRCC have a worse CS survival than patients with UC but when matched for prognostic features, there is no statistically significant difference in outcome.
Category: Genitourinary (including renal tumors)
Tuesday, March 20, 2012 1:00 PM
Poster Session IV # 93, Tuesday Afternoon