International Journal of Clinical Oncology

, Volume 24, Issue 6, pp 706–711 | Cite as

Squamous cell carcinoma of the bladder: poor response to neoadjuvant chemotherapy

  • Aaron Dotson
  • Allison May
  • Facundo Davaro
  • Syed Johar Raza
  • Sameer Siddiqui
  • Zachary HamiltonEmail author
Original Article



Squamous cell carcinoma (SCC) of the bladder is a rare, aggressive malignancy. Unlike urothelial cell carcinoma, SCC is resistant to chemotherapy and guidelines recommend radical cystectomy (RC) without neoadjuvant chemotherapy (NAC). We aimed to evaluate the current management and survival of patients with invasive SCC treated with or without NAC.


671 patients with invasive SCC bladder cancer from 2004 to 2015 in the National Cancer Data Base were identified. Patients were stratified by treatment with RC alone or NAC prior to RC (NAC + RC). Survival analysis was performed with Kaplan–Meier and Cox regression. Secondary outcomes included length of stay and readmission.


Of 671 patients, 92.8% were treated with RC alone and 7.2% with NAC + RC. Cox regression for mortality was performed including age, Charlson score, clinical stage, and NAC. Increased risk of mortality was noted with increasing age (OR 1.01, p = 0.023) and Charlson score of 1–3 (HR 1.58–1.68, p < 0.05). NAC did not confer survival advantage (HR 1.17, p = 0.46). On Kaplan–Meier analysis, the overall survival was equivalent (log-rank p = 0.804). Hospital stay and readmission were similar between RC and NAC + RC groups.


Analysis of a national tumor registry suggests a lack of overall survival benefit for NAC with localized, muscle invasive SCC of the bladder. Further research directed at chemotherapy regimens for SCC is needed to optimize treatment and improve survival outcomes.


Bladder cancer Squamous cell cancer Cystectomy Neoplasm invasion 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Division of Urology, Department of SurgerySaint Louis UniversitySt. LouisUSA

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