Accounts for less than 1% of all urinary bladder cancers.
Aggressive tumor with 68% of patients dead by 21 months.
Survival rates at 1,3 and 5 years are 56%, 23% and 16%, respectively.
Most patients in 6-7th decade, with male predominance and many with history of smoking.
Most patients present with gross hematuria.
Most patients present with advanced disease at the time of diagnosis.
Compared to other bladder cancers this lesion has a high tension for rapid growth and development of metastases.
1 year survival rate for T1 and T2 lesions 58% and for T3 and T4 patients it is about 25%.
Frequently admixed with other types of urothelial tumor in about 69% of cases.
Patients treated with cystectomy alone have very unfavorable outcomes.
Addition of chemotherapy to cystectomy improves survival rates.
In a study from M.D. Anderson Hospital 172 patients treated either with surgery versus neoadjuvant chemotherapy followed by surgery had a median overall survival of time of 18.3 months and 159.5 months, respectively (Siefer-Radtke A et al).
Skin the above study 5 year disease specific survival rates were 20% for those treated with initial surgery and 79% for those who received neoadjuvant chemotherapy and surgery.
Postoperative chemotherapy in the above study offered little additional benefit to patients undergoing initial surgery.
In the above study 62% of patients treated with neoadjuvant chemotherapy had their disease downstaged, while only 9% of patients who had initial surgery had similar downstaging.