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Willis DL , Flaig TW , Hansel DE , Milowsky MI , Grubb RL , Al-Ahmadie HA , Plimack ER , Koppie TM , McConkey DJ , Dinney CP , Hoffman VA , Droller MJ , Messing E , Kamat AM
Micropapillary bladder cancer: current treatment patterns and review of the literature
Urol Oncol. 2014 Aug;32(6) :826-32
PMID: 24931270    PMCID: PMC4687398    URL: https://www.ncbi.nlm.nih.gov/pubmed/24931270
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Abstract
OBJECTIVES: No guidelines exist for the management of micropapillary bladder cancer (MPBC) and most reports of this variant of urothelial carcinoma are case series comprising small numbers of patients. We sought to determine current practice patterns for MPBC using a survey sent to the Society of Urologic Oncology (SUO) and to present those results in the setting of a comprehensive review of the existing literature. MATERIALS AND METHODS: A survey developed by the Translational Science Working Group of the Bladder Cancer Advocacy Network-sponsored Think Tank meeting was distributed to members of the SUO. The results from 118 respondents were analyzed and presented with a literature review. RESULTS: Most survey respondents were urologists, with 80% considering bladder cancer their primary area of interest. Although 78% of the respondents reported a dedicated genitourinary pathologist at their institution, there were discrepant opinions on how a pathologic diagnosis of MPBC is determined as well as variability on the proportion of MPBC that is clinically significant. Among them, 78% treat MPBC differently than conventional urothelial carcinoma, with 81% reporting that they would treat cT1 MPBC with upfront radical cystectomy. However, the respondents had split opinions regarding the sensitivity of MPBC to cisplatin-based chemotherapy, which affected utilization of neoadjuvant chemotherapy in muscle-invasive disease. CONCLUSIONS: The management of MPBC is diverse among members of the SUO. Although most favors early cystectomy for cT1 MPBC, there is no consensus on the use of neoadjuvant chemotherapy for muscle-invasive MPBC.
Notes
Willis, Daniel L Flaig, Thomas W Hansel, Donna E Milowsky, Matthew I Grubb, Robert L Al-Ahmadie, Hikmat A Plimack, Elizabeth R Koppie, Theresa M McConkey, David J Dinney, Colin P Hoffman, Vanessa A Droller, Michael J Messing, Edward Kamat, Ashish M eng P30 CA016672/CA/NCI NIH HHS/ P50 CA091846/CA/NCI NIH HHS/ Review Urol Oncol. 2014 Aug;32(6):826-32. doi: 10.1016/j.urolonc.2014.01.020. Epub 2014 Jun 13.