Optimal Management of Non-Muscle Invasive Micropapillary Variant Urothelial Carcinoma: Possibility For Missed Chance at Cure?

Bladder cancer is a common disease in the US, affecting upwards of 74,000 patients yearly (1) . Micropapillary bladder carcinoma (MPBC) is a sub type variant which was described in 1994 from our institution and which has gained in recognition since then.

Due to small numbers of patients, most series other than those from major cancer centers have been in the single or low double digits. We have previously reported on the relative 'resistance' of this variant subtype to intravesical immunotherapy and advocated for early radical cystectomy to provide optimal cancer control for our patients. This is in contrast to the undisputed clinical benefit of Bacille Calmette and Guérin (BCG) immunotherapy for patients with conventional non-muscle invasive bladder cancer (NMIBC) in reducing not only recurrence but also progression rates. However, since some have argued that intravesical immunotherapy is an appropriate mode of therapy even for MPBC, there is potential for missed chance of cure. This article is protected by copyright. All rights reserved.

BJU international. 2016 Feb 24 [Epub ahead of print]

Stephen B Williams, Ashish M Kamat

Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas., Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.