Transitional cell carcinoma

Refers to urothelial carcinoma.

Arises from any urothelial surface including the urethra, prostate, bladder, ureter, or renal pelvis.

Most commonly originates from bladder.

about 74,700 new cases reported in 2014.

90% of urothelial tumors begin in the bladder, while only 8% originate in the renal pelvis and 2% in the ureter and urethra.

6% of all patients with TCC at diagnosis have metastatic disease.

Metastatic TCC is associated with a median survival of 16.9 months.

Metastatic transitional carcinoma is among the top causes of cancer deaths, accounting for 13,000 deaths annually in the US.

Incidence of metastatic transitional cell carcinoma has been stable for the last two decades.

Link with exposure to cigarettes and certain chemicals.

30% present with muscle invasive or metastatic disease.

Median survival of patients with metastatic disease who received platinum based therapy is about 14 months.

Up to 50% of patients with muscle invasive disease will develop metastatic disease.

Metastatic disease may be responsive to various chemotherapy agents including cyclophosphamide, methotrexate, vinblastine, doxorubicin, cis-platinum, Gemcitabine and taxanes.

MVAC vs. Gemcitabine plus cis-platinum are equivalent.

More than 70% of patients with metastatic disease relapse at the sites of initial disease.

Long-term survival after surgical resection is seen in only 20 to 25% of patients with gross nodal disease.

Surgical resection of residual disease after chemotherapy may improve outcome.

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