Intratumoral Heterogeneity of Bladder Cancer by Molecular Subtypes and Histologic Variants.


:Molecular subtyping may inform on prognosis and treatment response in bladder cancer. However, intratumoral molecular heterogeneity is not well studied in this disease and could complicate efforts to use molecular subtyping to guide patient management. To investigate intratumoral heterogeneity in bladder cancer, we examined molecular subtypes in a consecutive, retrospective cystectomy series of histologic variant bladder cancers and conventional urothelial carcinomas co-occurring with them. Molecular subtypes were assigned as per the approach reported by Lund University, an approach that incorporates cell cycle alterations and markers of differentiation, to give the urothelial-like, genomically unstable, basal-squamous, mesenchymal-like, and neuroendocrine-like subtypes. The majority (93%) of tumors were classified as urothelial like, genomically unstable, or basal squamous. Among patients with more than one tumor histology, 39% demonstrated molecular heterogeneity among the different tumor histologies. This was greatest for the basal-squamous subtype, 78% of which co-occurred with either urothelial-like or genomically unstable carcinoma (among cases with multiple histologies). In contrast, there was no co-occurrence of urothelial-like and genomically unstable carcinoma in the same patient. The findings indicate that bladder cancer is often molecularly heterogeneous, particularly in the basal-squamous subtype. This raises the concern for sampling error in laboratory tests that guide therapy based on molecular subtyping. Patient summary: In this report, we investigated molecular diversity among different areas from the same tumor in patients with bladder cancer. We found that different areas from the same tumor are often molecularly different. We conclude that this biological diversity must be taken into account when interpreting clinical molecular tests performed on bladder cancer samples.


Eur Urol


European urology


Warrick JI,Sjödahl G,Kaag M,Raman JD,Merrill S,Shuman L,Chen G,Walter V,DeGraff DJ




Has Abstract


2019-01-01 00:00:00














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    authors: Marandola P,Lardennois B,Ploton D,Derenzini M,Treré D,Campo B,Valentino V,Tronci A,Roggia A,Broggini P

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    authors: Van Poppel H,Hogenhout R,Albers P,van den Bergh RCN,Barentsz JO,Roobol MJ

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    abstract::Alpha1-adrenoceptor antagonists have been shown to decrease both the voiding and storage symptoms of benign prostatic hyperplasia (BPH). Based on the assumption that these symptoms can be attributed to the consequences of the increase in outflow resistance caused by noradrenaline stimulation of stromal alpha1-adrenoce...

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    authors: Andersson KE

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    authors: Sooriakumaran P,Nyberg T,Akre O,Widmark A,Hamdy F,Graefen M,Carlsson S,Steineck G,Wiklund NP

    更新日期:2017-09-01 00:00:00

  • Impotence due to corporeal veno-occlusive dysfunction: long-term follow-up of venous surgery.

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    authors: Wespes E,Delcour C,Preserowitz L,Herbaut AG,Struyven J,Schulman C

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  • Iodine-125-seed implantation combined with external radiotherapy under potentially curative intention in patients with advanced stage-C prostatic cancer.

    abstract::We report on 18 patients, aged 43-77 years, with clinical stage-C adenocarcinoma of the prostate, primarily treated by pelvic lymphadenectomy and 125I-seed implantation. After lymphadenectomy, the staging assessment differed from the preoperative diagnosis as follows: 4 patients were classified as stage C; 6 as D1, an...

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    authors: Frick J,Scrinzi U,Kunit G,Kogelnik HD

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    authors: Lipponen PK,Collan Y,Eskelinen MJ,Pesonen E,Sotarauta M

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  • Urethrogluteal fistula occurring after radical cystectomy for bladder cancer.

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  • Urothelial differentiation in vesicoureteric reflux and other urological disorders of childhood: a comparative study.

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    authors: Garthwaite MA,Thomas DF,Subramaniam R,Stahlschmidt J,Eardley I,Southgate J

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  • The use of polymer (Hem-o-lok) clips for management of the renal hilum during laparoscopic nephrectomy.

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    authors: Baumert H,Ballaro A,Arroyo C,Kaisary AV,Mulders PF,Knipscheer BC

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  • Upper urinary tract involvement after cystectomy and ileal conduit diversion for primary bladder carcinoma.

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  • Chemical analysis of renal stones from 377 Belgian patients by using qualitative or quantitative methods.

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    authors: Everaert K,Raes A,Hoebeke P,Samijn W,Delanghe J,Vande Wiele C,Vande Walle J

    更新日期:1998-12-01 00:00:00

  • Prostate Cancer Registries: Current Status and Future Directions.

    abstract:CONTEXT:Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. OBJECTIVE:To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. EVIDENCE ACQUISITIO...

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