Burger - Figure 23

Squamous differentation

FIG. 23:  Squamous cell carcinoma is rare in North America and the EU, where they  represent about 5% of bladder cancer cases, but up to 40% of all cases show some squamous differentiation.[7]  In East Africa and in the Middle East, this picture is changing dramatically, and up to 75% of all cases have been suggested to be squamous rather than urothelial.[7]  Squamous cell carcinoma is linked to schistosomiasis, but not with the human papilloma virus (HPV).[11]  It is also linked to chronic urinary tract infection, to the presence of bladder calculi, and to exposure to radiation, of the type and dose administered in treatment of cancer.

Squamous cell bladder cancer has a pronounced propensity to progress, and NMI bladder cancer appears to progress to invasive tumor stage in about 50% of all cases, so a timely diagnosis is important. 

There are data suggesting that T1 and T2 cases fare comparably following radical cystectomy,[14] indicating the benefit of complete surgical resection, but any advanced stage has a poor outcome.

References

[7]

Klaile Y, Schlack K, Boegemann M, et al. Variant histology in bladder cancer: how it should change the management in non-muscle invasive and muscle invasive disease? Transl Androl Urol. 2016;5:692−701 https://dx.doi.org/10.21037%2Ftau.2016.06.13

 

[11]

Humphrey PA, Moch H, Cubilla AL The 2016 WHO classification of tumours of the urinary system and male genital organs-Part B: Prostate and bladder tumours. Eur Urol. 2016;70:106−19  http://dx.doi.org/10.1016/j.eururo.2016.02.028

[14]

Kim SP, Frank I, Cheville JC, et al. The impact of squamous and glandular differentiation on survival after radical cystectomy for urothelial carcinoma. J Urol. 2012;188:405−9  http://dx.doi.org/10.1016/j.juro.2012.04.020