Update of the International Consultation on Urological Diseases on bladder cancer 2018: non-urothelial cancers of the urinary bladder

Abstract

Purpose

To provide a comprehensive update of the joint consultation of the International Consultation on Urological Diseases (ICUD) for the diagnosis and management of non-urothelial cancer of the urinary bladder.

Methods

A detailed analysis of the literature was conducted reporting on the epidemiology, etiology, diagnosis, treatment and outcomes of non-urothelial cancer of the urinary bladder. An international, multidisciplinary expert committee evaluated and graded the evidence according to the Oxford System of Evidence-based Medicine modified by the ICUD.

Results

The major non-urothelial cancers of the urinary bladder are squamous cell carcinoma, adenocarcinoma, and neuroendocrine tumors. Several other non-urothelial tumors are rare but important to identify because of their aggressive behavior when compared to urothelial bladder tumors. Radical cystectomy and urinary diversion, preceded by neoadjuvant radiation or chemotherapy in some of these tumors, is the main method or treatment for resectable disease. Adjuvant therapy is not usually successful and no novel targeted or immunotherapeutic agents have been identified to provide benefit. Patients with small cell neuroendocrine tumors of the bladder should be offered chemotherapy before surgery. Because non-urothelial cancers are usually locally advanced and/or metastatic at the time of diagnosis, 5-year survival is generally poor.

Conclusions

Non-urothelial cancers of the urinary bladder are rare and mostly lack established protocols for treatment. The prognosis of most of these tumors is poor because they are usually advanced at the time of diagnosis. A multimodal treatment approach should be considered to improve outcomes.

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Fig. 1

(with permission from BJU International vol. 107(2):206–2011)

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Authors

Contributions

SA: Data collection, manuscript writing. IA-C: Data collection, manuscript writing. PM: Data collection, manuscript writing. RK: Data collection, manuscript writing. KGN: Data collection, manuscript writing. GPP: Data collection, manuscript writing. MIP: Data collection, manuscript writing. MRR: Data collection, manuscript writing. AL-B: Project supervision, manuscript writing and editing. BRK: Project supervision, manuscript writing and editing.

Corresponding author

Correspondence to Shaheen Alanee.

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I testify on behalf of all co-authors that our article submitted to World Journal of Urology has not been published in whole or in part elsewhere, is not currently being considered for publication in another journal, and that all authors have been personally and actively involved in substantive work leading to the manuscript, and will hold themselves jointly and individually responsible for its content.

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This research does not involve human or animal subjects. This work is a review of the literature. No institutional review board was required because no active research was preformed.

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Alanee, S., Alvarado-Cabrero, I., Murugan, P. et al. Update of the International Consultation on Urological Diseases on bladder cancer 2018: non-urothelial cancers of the urinary bladder. World J Urol 37, 107–114 (2019). https://doi.org/10.1007/s00345-018-2421-5

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Keywords

  • Bladder cancer
  • Non-urothelial
  • ICUD
  • Update