Variant tumor histology in patients with transitional cell carcinoma (TCC) is an indication for neoadjuvant chemotherapy, according to researchers.
Wassim Kassouf, MD, and his colleagues at the M.D. Anderson Cancer Center in Houston studied 147 patients with bladder cancer who were enrolled in one of two prospective randomized trials evaluating the role of neoadjuvant chemotherapy followed by radical cystectomy. Tumor histology was pure TCC in 96 patients (65%), TCC plus variant histology in 48 (33%), and pure variant histology in three (2%). Neoadjuvant chemotherapy downstaged 55% of tumors in the patients with pure TCC compared with 45% in patients with TCC plus variant histology. Five-year disease-specific survival for patients overall was 60% after a median follow-up of 43 months.