What are the prognosis and predictive factors of squamous cell carcinoma of the urinary bladder?

Updated: Jun 11, 2019
  • Author: Muhammad T Idrees, MD; Chief Editor: Liang Cheng, MD  more...
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Answer

Sex and age have not proved prognostically significant in squamous cell bladder cancer. [71] Tumor stage, lymph node involvement, and tumor grade have been shown to be of independent prognostic value. [50, 70]  Standard therapy is radical cystectomy, [6] and radical surgery appears to result in an improved survival rate as compared to radiation therapy, [72]  particularly for nonmetastatic squamous cell carcinoma of the bladder, [72] and/or chemotherapy, whereas neoadjuvant radiation improves the outcome in locally advanced tumors. [73]

Pathologic stage is the most important prognostic factor in the outcome of squamous cell carcinoma of the bladder. [71] In one relatively larger series of 154 cases, the overall 5-year survival was 56% for pT1 and 68% for pT2 tumors. However, the 5-year survival for pT3 and pT4 tumors was only 19%.

Several studies have demonstrated grading to be a significant morphologic parameter. [71] In one series, 5-year survival rates for grade 1, 2, and 3 squamous cell carcinoma were 62%, 52%, and 35%, respectively. [71] In the same study of patients undergoing cystectomy, the investigators suggested that a higher number of newly formed blood vessels predicts unfavorable disease outcome. [71]

A study by Youssef et al found that fibroblast growth factor overexpression is associated with aggressive pathologic features and worse outcomes after radical cystectomy for squamous cell carcinoma of the urinary bladder. [74]  The authors added that this suggested a good prognostic and possible therapeutic role.

More studies need to be performed to elucidate the impact of genetic changes on the prognosis of squamous cell carcinoma of the bladder. To date, there is no convincing evidence of genetic factors affecting the outcome.


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