Early Detection and Gemcitabine/Cisplatin Combination Positively Effect Survival in Sarcomatoid Carcinoma of the Urinary Bladder

Background and
Objectives: This study aimed to present the clinicopathological characteristics and treatmentof patients with bladder carcinoma with sarcomatoid differentiation at our institution.
Methods: Between 1995-2009, 950 patients were followed-up for bladder carcinoma. Among them, 14 patients with sarcomatoid carcinomawere retrospectively reviewed, and their clinical, pathological features and treatment were recorded.
Results:Median age of the patients was 65 years (range: 41-86 years), 12 (86%) being male and 2 (14%) female. All thepatients presented with hematuria and 11 (88%) had a history of smoking. The tumor growth pattern was solidin 10 patients, papillary in 2, and mixed in 2. In all, 5 of the patients had urothelial carcinoma with sarcomatoiddifferentiation and 9 were diagnosed with sarcomatoid carcinoma. Five patients underwent radical cystectomywith ileal conduit surgery, 2 patients refused cystectomy, and 8 patients underwent re-TUR. Following diagnosis,12 of the patients died in mean 10.7 months (range: 1-48 months).
Conclusion: Urothelial carcinomas withsarcomatoid features are aggressive and are usually at advanced stage at the time of diagnosis. The outcomesof multimodal treatment are not satisfactory. Significant findings of the present study are that early diagnosispositively affect survival and that gemcitabine and cisplatin in combination can positively affect survival.