What Factors Affect a Prognosis for Squamous Cell Carcinoma?
Epithelial malignancies originated from the bladder mucosa. Under the microscope, cancer cells have a single squamous cell phenotype, referred to as bladder squamous cell carcinoma. It is a subtype of bladder cancer. The proportion of bladder squamous cell carcinoma in bladder malignancies worldwide varies widely. It is 1% in the United Kingdom and 3% to 7% in the United States. The incidence reported in our country It is 0.58% to 5.55%, but in areas with a high incidence of schistosomiasis, such as Egypt, it can account for 75%. There are more male patients than female patients, and the ratio of male to female is about 1.25 to 1.8: 1. The age of onset of bladder squamous cell carcinoma is usually 10 to 20 years younger than the age of bladder urothelial carcinoma, and the age of onset is 50 to 70 years. Compared with bladder urothelial carcinoma, bladder squamous cell carcinoma has high malignancy, more invasiveness, rapid growth, early metastasis, and poor prognosis. 50% of patients with invasive bladder cancer have clinically undetectable metastatic lesions, but bladder squamous cell carcinoma caused by schistosomiasis is usually well-differentiated, with low lymph node metastasis and distant metastasis rates.
- English name
- squamous cell carcinoma of bladder
- Visiting department
- Oncology
- Multiple groups
- 50 to 70 years old
- Common locations
- Bladder mucosa
- Common causes
- Chronic cystitis, bladder stones, bladder schistosomiasis, long-term indwelling catheters, etc.
- Common symptoms
- Intermittent gross hematuria with frequent urination, urgency, dysuria, weight loss, anemia, poor urination, obstruction of urinary flow
Basic Information
Causes of Bladder Squamous Cell Carcinoma
- The pathogenesis of bladder squamous cell carcinoma is unknown, and most of them are thought to be malignant tumors formed after long-term chronic stimulation leading to metaplasia of urothelial squamous epithelium. Long-term chronic irritation factors include chronic cystitis, bladder stones, schistosomiasis of the bladder, long-term indwelling catheter, and long-term use of cyclophosphamide may be related to the development of bladder squamous cell carcinoma.
Clinical manifestations of bladder squamous cell carcinoma
- The most common clinical manifestations of patients with bladder squamous cell carcinoma are hematuria with bladder irritation, which is manifested by intermittent gross hematuria with frequent urination, urgency, and dysuria. The main feature is dysuria, which is characterized by severe symptoms and difficult to alleviate with anti-inflammatory drugs. Other clinical manifestations include weight loss, anemia, poor urination, and obstruction of urinary flow. Some patients have bladder stones, and some have a history of bladder stones.
Diagnosis of bladder squamous cell carcinoma
- Cystoscopy plus biopsy is the most important method for diagnosing bladder cancer. Under cystoscopy, tumors are mostly clumps. Most tumors are large, cauliflower-like, polyp-like, and the surface of the tumor is often accompanied by necrosis and ulcers. Some tumors are flat, irregularly bordered, or ulcerated. A bladder examination can also perform a biopsy of the tumor or suspicious lesion to confirm the pathological diagnosis. B-ultrasound, CT, and MRI examinations can show tumor size, invasion depth and extent, and presence or absence of pelvic lymphadenopathy to help clinical staging.
Bladder Squamous Cell Carcinoma Treatment
- For patients with bladder squamous cell carcinoma, radical total cystectomy + pelvic lymphadenectomy + urinary diversion are preferred. This is the standard treatment. Partial bladder resection may also be considered in patients with isolated localized bladder squamous cell carcinoma. For patients with metastasis, comprehensive treatment based on oncology should be given.
Prognosis of bladder squamous cell carcinoma
- Factors affecting the prognosis of patients with bladder squamous cell carcinoma are tumor stage, grade, and whether there is metastasis to lymph nodes. Most literature reports that patients with bladder squamous cell carcinoma have a poor prognosis, with a 1-year mortality rate of 55% to 76% and a 5-year survival rate of 7.4% to 15.3%. Surgery combined with preoperative chemotherapy, postoperative radiotherapy or chemotherapy can improve the efficacy.