Predominantly squamous cell carcinoma of the bladder is most commonly found in the environment of schistosomiasis in the Middle East, a context that is outside the scope of this chapter.
In the western, central squamous differentiation are commonly found in patients with invasive, non-papillary TCC. As is the case with focal glandular differentiation, we know you do not have clinical significance of this finding. By contrast, pure squamous cell carcinomas are rare, and show a very particular clinical expression. The most common scenario for (non-schistosomiasis) is that the chronic irritation squamous cell cancer, usually either urolithiasis (particularly staghorn calculi) or chronic catheters in patients with paraplegia and neurogenic bladder diseases such as MS. It is typical to see keratinizing squamous metaplasia, dysplasia often in areas adjacent to these cancers.
Surgery is the mainstay of therapy for squamous cell cancer. Local control is often a bigger problem than the progression from a distance, marked difference to the situation with conventional TCC. The sensitivity to chemotherapy is universally reported to be lower for the conventional squamous cell cancer of the CTP, which further reinforces the importance of primary surgical management. Unfortunately, when these cancers are recurrent or metastatic chemotherapy expectations are limited. However, there are certainly patients have excellent responses, and there is therefore difficult to assess the risk-benefit of a trial of chemotherapy. In our limited experience, we find the combination of gemcitabine (900mgm-2 for 90 minutes), cisplatin (50mgm-2), and ifosfamide (1000mgm-2) given every 14 days to be the most attractive pattern no a clinical trial.
Interestingly, lung metastases of carcinoma of the bladder tend to cavitation, the behavior is not typical of other histologies. Our experience in trying to administer chemotherapy in the special context of patients with paraplegia (or other diseases causing neurogenic bladder) is uniformly unsatisfactory, and we can not support the use of conventional treatments such as MVAC in this context.
In the western, central squamous differentiation are commonly found in patients with invasive, non-papillary TCC. As is the case with focal glandular differentiation, we know you do not have clinical significance of this finding. By contrast, pure squamous cell carcinomas are rare, and show a very particular clinical expression. The most common scenario for (non-schistosomiasis) is that the chronic irritation squamous cell cancer, usually either urolithiasis (particularly staghorn calculi) or chronic catheters in patients with paraplegia and neurogenic bladder diseases such as MS. It is typical to see keratinizing squamous metaplasia, dysplasia often in areas adjacent to these cancers.
Surgery is the mainstay of therapy for squamous cell cancer. Local control is often a bigger problem than the progression from a distance, marked difference to the situation with conventional TCC. The sensitivity to chemotherapy is universally reported to be lower for the conventional squamous cell cancer of the CTP, which further reinforces the importance of primary surgical management. Unfortunately, when these cancers are recurrent or metastatic chemotherapy expectations are limited. However, there are certainly patients have excellent responses, and there is therefore difficult to assess the risk-benefit of a trial of chemotherapy. In our limited experience, we find the combination of gemcitabine (900mgm-2 for 90 minutes), cisplatin (50mgm-2), and ifosfamide (1000mgm-2) given every 14 days to be the most attractive pattern no a clinical trial.
Interestingly, lung metastases of carcinoma of the bladder tend to cavitation, the behavior is not typical of other histologies. Our experience in trying to administer chemotherapy in the special context of patients with paraplegia (or other diseases causing neurogenic bladder) is uniformly unsatisfactory, and we can not support the use of conventional treatments such as MVAC in this context.