Sungmin Woo1, Soleen Ghafoor2, Jeeban P Das3, Natalie Gangai3, Alvin C Goh4, Herbert Alberto Vargas3. 1. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: woos@mskcc.org. 2. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zürich, Switzerland. 3. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY. 4. Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
Abstract
OBJECTIVES: Plasmacytoid urothelial carcinomas (PUC) of the bladder are rare variants known for diffuse and infiltrative spread, however their magnetic resonance imaging (MRI) features are not well established. We aimed to evaluate MRI features of PUC of the bladder and their association with survival. METHODS AND MATERIALS: This retrospective single-center study included 41 patients with pathologically-proven bladder PUC of the bladder that underwent pre-treatment MRI between January 2000 and March 2020. Two radiologists reviewed MRIs independently followed by consensus with a third radiologist. On MRI, tumor extent, size, Vesical Imaging-Reporting and Data System (VI-RADS) scores (≥4, muscle-invasive; 5, extravesical extension [EVE]), pelvic peritoneal spread (PPS), hydronephrosis, pelvic adenopathy and clinicopathological factors of age, gender, pathological stage, and treatment type were extracted. Kaplan-Meier curves and Cox proportional-hazards models were used to evaluate association with survival. RESULTS: Thirty-two men and 9 women (median age 70 years, IQR 64-76) were included. Most were muscle-invasive (n = 30 [73.2%]). On MRI, most tumors were diffuse (n = 28 [68.3%]), >5 cm (n = 30 [73.2%]), VI-RADS 4 to 5 (n = 36 [87.8%]) with features of EVE and (n = 31 [75.6%]) and PPS (n = 25 [61.0%]). Variables associated with survival were: Larger tumors (>5 cm; hazard ratio [HR] = 5.0; 95% confidence interval [CI] 1.6-15.5; P < 0.01), diffuse extent (HR = 4.0; 95% CI 1.4-11.2; P = 0.01), EVE (HR = 4.5; 95% CI 1.5-13.6; P < 0.01), PPS (HR = 3.0; 95% CI 1.2-7.4; P = 0.01), hydronephrosis (HR = 13.7; 95% CI 3.1-60.9; P < 0.01), pathologic stage (≥pT3 vs. pT1; HR = 5.6; 95% CI 1.3-22.0; P = 0.02), and margin positivity (HR = 4.4 [95% CI 1.2-16.4], P = 0.03). CONCLUSION: PUCs of the bladder are commonly large, diffuse VI-RADS score 4 to 5 tumors with MRI features of EVE and PPS. These features and pathological stage were associated with survival.
OBJECTIVES: Plasmacytoid urothelial carcinomas (PUC) of the bladder are rare variants known for diffuse and infiltrative spread, however their magnetic resonance imaging (MRI) features are not well established. We aimed to evaluate MRI features of PUC of the bladder and their association with survival. METHODS AND MATERIALS: This retrospective single-center study included 41 patients with pathologically-proven bladder PUC of the bladder that underwent pre-treatment MRI between January 2000 and March 2020. Two radiologists reviewed MRIs independently followed by consensus with a third radiologist. On MRI, tumor extent, size, Vesical Imaging-Reporting and Data System (VI-RADS) scores (≥4, muscle-invasive; 5, extravesical extension [EVE]), pelvic peritoneal spread (PPS), hydronephrosis, pelvic adenopathy and clinicopathological factors of age, gender, pathological stage, and treatment type were extracted. Kaplan-Meier curves and Cox proportional-hazards models were used to evaluate association with survival. RESULTS: Thirty-two men and 9 women (median age 70 years, IQR 64-76) were included. Most were muscle-invasive (n = 30 [73.2%]). On MRI, most tumors were diffuse (n = 28 [68.3%]), >5 cm (n = 30 [73.2%]), VI-RADS 4 to 5 (n = 36 [87.8%]) with features of EVE and (n = 31 [75.6%]) and PPS (n = 25 [61.0%]). Variables associated with survival were: Larger tumors (>5 cm; hazard ratio [HR] = 5.0; 95% confidence interval [CI] 1.6-15.5; P < 0.01), diffuse extent (HR = 4.0; 95% CI 1.4-11.2; P = 0.01), EVE (HR = 4.5; 95% CI 1.5-13.6; P < 0.01), PPS (HR = 3.0; 95% CI 1.2-7.4; P = 0.01), hydronephrosis (HR = 13.7; 95% CI 3.1-60.9; P < 0.01), pathologic stage (≥pT3 vs. pT1; HR = 5.6; 95% CI 1.3-22.0; P = 0.02), and margin positivity (HR = 4.4 [95% CI 1.2-16.4], P = 0.03). CONCLUSION: PUCs of the bladder are commonly large, diffuse VI-RADS score 4 to 5 tumors with MRI features of EVE and PPS. These features and pathological stage were associated with survival.
Authors: Yair Lotan; Amit Gupta; Shahrokh F Shariat; Ganesh S Palapattu; Amnon Vazina; Pierre I Karakiewicz; Patrick J Bastian; Craig G Rogers; Gilad Amiel; Paul Perotte; Mark P Schoenberg; Seth P Lerner; Arthur I Sagalowsky Journal: J Clin Oncol Date: 2005-08-22 Impact factor: 44.544
Authors: Bastian Keck; Robert Stoehr; Sven Wach; Anja Rogler; Ferdinand Hofstaedter; Jan Lehmann; Rodolfo Montironi; Mathilde Sibonye; Hans M Fritsche; Antonio Lopez-Beltran; Jonathan I Epstein; Bernd Wullich; Arndt Hartmann Journal: Int J Cancer Date: 2010-12-01 Impact factor: 7.396
Authors: Miguel Angel Arrabal-Polo; María Del Carmen Cano-García; Paolo Fabiano; Verónica Martínez-Pagán; Matías Barayobre; Javier González García Journal: Int Urol Nephrol Date: 2015-06-07 Impact factor: 2.370
Authors: Maha Ibrahim Metwally; Nesma Adel Zeed; Enas Mahmoud Hamed; Al Shaimaa Fathi Elshetry; Rabab Mahmoud Elfwakhry; Ahmed M Alaa Eldin; Ahmed Sakr; Sameh Abdelaziz Aly; Walid Mosallam; Yara Mohammed Ahmad Ziada; Rawda Balata; Ola A Harb; Mohammad Abd Alkhalik Basha Journal: Eur Radiol Date: 2021-02-19 Impact factor: 5.315
Authors: Guru Sonpavde; Myrna M Khan; Robert S Svatek; Richard Lee; Giacomo Novara; Derya Tilki; Seth P Lerner; Gilad E Amiel; Eila Skinner; Pierre I Karakiewicz; Patrick J Bastian; Wassim Kassouf; Hans-Martin Fritsche; Jonathan I Izawa; Vincenzo Ficarra; Colin P Dinney; Yair Lotan; Yves Fradet; Shahrokh F Shariat Journal: BJU Int Date: 2010-11-19 Impact factor: 5.588
Authors: Melanie D Fox; Li Xiao; Miao Zhang; Ashish M Kamat; Arlene Siefker-Radtke; Li Zhang; Colin P Dinney; Bogdan Czerniak; Charles C Guo Journal: Am J Clin Pathol Date: 2017-05-01 Impact factor: 2.493