Micropapillary bladder cancer: Current treatment patterns and review of the literature

Daniel L. Willis, Thomas W. Flaig, Donna E. Hansel, Matthew I. Milowsky, Robert L. Grubb, Hikmat A. Al-Ahmadie, Elizabeth R. Plimack, Theresa Koppie, David J. McConkey, Colin P. Dinney, Vanessa A. Hoffman, Michael J. Droller, Edward Messing, Ashish M. Kamat

Research output: Contribution to journalArticle

28 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)826-832
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume32
Issue number6
DOIs
StatePublished - 2014

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Urinary Bladder Neoplasms
Therapeutics
Cystectomy
Drug Therapy
Carcinoma
Muscles
Surveys and Questionnaires
Cisplatin
Guidelines

Keywords

  • Bladder cancer
  • Micropapillary
  • Review
  • Survey

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Willis, D. L., Flaig, T. W., Hansel, D. E., Milowsky, M. I., Grubb, R. L., Al-Ahmadie, H. A., ... Kamat, A. M. (2014). Micropapillary bladder cancer: Current treatment patterns and review of the literature. Urologic Oncology: Seminars and Original Investigations, 32(6), 826-832. https://doi.org/10.1016/j.urolonc.2014.01.020

Micropapillary bladder cancer : Current treatment patterns and review of the literature. / Willis, Daniel L.; Flaig, Thomas W.; Hansel, Donna E.; Milowsky, Matthew I.; Grubb, Robert L.; Al-Ahmadie, Hikmat A.; Plimack, Elizabeth R.; Koppie, Theresa; McConkey, David J.; Dinney, Colin P.; Hoffman, Vanessa A.; Droller, Michael J.; Messing, Edward; Kamat, Ashish M.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 32, No. 6, 2014, p. 826-832.

Research output: Contribution to journalArticle

Willis, DL, Flaig, TW, Hansel, DE, Milowsky, MI, Grubb, RL, Al-Ahmadie, HA, Plimack, ER, Koppie, T, McConkey, DJ, Dinney, CP, Hoffman, VA, Droller, MJ, Messing, E & Kamat, AM 2014, 'Micropapillary bladder cancer: Current treatment patterns and review of the literature', Urologic Oncology: Seminars and Original Investigations, vol. 32, no. 6, pp. 826-832. https://doi.org/10.1016/j.urolonc.2014.01.020
Willis, Daniel L. ; Flaig, Thomas W. ; Hansel, Donna E. ; Milowsky, Matthew I. ; Grubb, Robert L. ; Al-Ahmadie, Hikmat A. ; Plimack, Elizabeth R. ; Koppie, Theresa ; McConkey, David J. ; Dinney, Colin P. ; Hoffman, Vanessa A. ; Droller, Michael J. ; Messing, Edward ; Kamat, Ashish M. / Micropapillary bladder cancer : Current treatment patterns and review of the literature. In: Urologic Oncology: Seminars and Original Investigations. 2014 ; Vol. 32, No. 6. pp. 826-832.
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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.",
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AU - Milowsky, Matthew I.

AU - Grubb, Robert L.

AU - Al-Ahmadie, Hikmat A.

AU - Plimack, Elizabeth R.

AU - Koppie, Theresa

AU - McConkey, David J.

AU - Dinney, Colin P.

AU - Hoffman, Vanessa A.

AU - Droller, Michael J.

AU - Messing, Edward

AU - Kamat, Ashish M.

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N2 - 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.

AB - 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.

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