Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer

Bladder cancer is the ninth most common malignancy worldwide, with urothelial carcinoma (UC) representing the predominant histopathological subtype. UC may present as pure urothelial carcinoma (PUC), or alongside other variant histologies (VHs), with squamous differentiation in UC (SD) being the most frequently observed variant. The present study provides a population-based insight into the survival outcomes of patients with SD compared with PUC in early-stage disease. The present retrospective, observational study analyzed pathology reports from all cystectomies (n=632) performed at Uludag University Faculty of Medicine (Bursa, Turkey) between December 2010 and December 2023. A total of 23 patients with SD and 45 patients with PUC were evaluated; all of the patients had pathological stage T2N0 (pT2N0). The median follow-up period was 5.27 years (range, 0.23-16.60). Kaplan-Meier survival analysis demonstrated no statistically significant difference in disease-free survival (DFS) or overall survival (OS) between the SD and PUC groups. Univariate Cox regression analysis identified that age at diagnosis was a potential prognostic factor of both DFS and OS. The findings suggest that SD does not significantly affect DFS or OS in patients with pT2N0 UC. However, further prospective, multicenter, large-scale studies are warranted to validate and expand upon these findings.