Mp08-18 Metastatic Behavior of Urothelial Carcinoma Variant Histology: A Comprehensive NCDB Analysis

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP08)1 May 2024MP08-18 METASTATIC BEHAVIOR OF UROTHELIAL CARCINOMA VARIANT HISTOLOGY: A COMPREHENSIVE NCDB ANALYSIS Arthur P. Drouaud, Vincent E. Xu, Ryan M. Antar, Alejandro Velasquez, and Michael J. Whalen Arthur P. DrouaudArthur P. Drouaud , Vincent E. XuVincent E. Xu , Ryan M. AntarRyan M. Antar , Alejandro VelasquezAlejandro Velasquez , and Michael J. WhalenMichael J. Whalen View All Author Informationhttps://doi.org/10.1097/01.JU.0001008780.87855.57.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder cancer (BCa) with variant histology is notably aggressive and not as well studied as pure urothelial carcinoma. The characteristics of variant BCa in the setting of metastatic disease may contribute to treatment response or resistance and subsequent disease progression. In this study, we sought to assess the impact of histological subtypes on sites of metastasis in metastatic BCa. METHODS: The National Cancer Database was queried from 2004 to 2019 to analyze cT1-4 cN0-3 cM1 patients with urothelial and variant histology BCa. The primary endpoint was the presence of metastasis to different organs, including the liver, lungs, bone, brain, and distant lymph nodes. Binomial Logistic regression was performed to determine the impact of variant histology on metastatic sites while controlling for tumor size, age, sex, race, income, insurance, regional status, and facility type. RESULTS: In our study of 5,828 patients, we observed distinct metastatic patterns across various histologic subtypes. Notably, patients with small cell histology, the second most common variant histology, were more likely to have liver metastasis (OR: 4.229 3.343-5.350) while less likely to have lung metastases (OR: 0.547 0.416-0.721). Squamous cell carcinoma decreased the odds of bone metastasis (OR: 0.440 0.301-0.645). Adenocarcinoma did not exhibit a statistically significant variation in the odds ratio for any of the metastatic sites. Micropapillary variants were less likely to metastasize to the lungs (OR: 0.158 0.049-0.513) but more likely to the brain (OR: 3.214 1.107-9.327) and non-regional lymph nodes (OR: 2.660 1.341-5.277). Sarcomatoid subtypes had higher lung metastasis rates (OR: 1.858 1.232 -2.804). CONCLUSIONS: This study provides a comprehensive analysis of the limited research regarding metastatic BCa and variant histology. Our analysis underscores each subtype exhibiting heterogeneous metastatic tropism. Importantly, these findings may illustrate the role of routine somatic gene expression profiling to guide adequate staging and treatment intensification and to offer a foundation for future studies of variant BCa care. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e123 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Arthur P. Drouaud More articles by this author Vincent E. Xu More articles by this author Ryan M. Antar More articles by this author Alejandro Velasquez More articles by this author Michael J. Whalen More articles by this author Expand All Advertisement PDF downloadLoading ...