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Assessing the impact of time to cystectomy for variant histology of urothelial bladder cancer

Urology Sep 28, 2019

Lin-Brande M, Pearce SM, Ashrafi AN, et al. - A total of 363 patients with cT2-T4N0M0 urothelial carcinoma who underwent radical cystectomy without perioperative intravesical and/or systemic therapy from 2003 to 2014 were recruited to ascertain whether the timing of radical cystectomy for variant histology of urothelial carcinoma had an influence on survival. When contrasted with those with pure urothelial carcinoma, individuals with variant histology were more inclined to show up with the extravesical disease, be upstaged, have a lymphovascular invasion and have lymph node metastasis at radical cystectomy. Between pure urothelial and variant histology, the median days to radical cystectomy did not vary. Every month in delay was correlated with worse overall survival for variants, on multivariable analysis controlling for age, comorbidities, tumor stage, lymph node status, lymphovascular invasion, and surgical margins. Those with variant histology had statistically poorer survival at an 8-week delay or longer. Thus, for individuals with variant histology, delays in surgery were related to a heightened risk of death.
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