Background: Pure squamous cell carcinoma (SCC) is a rare entity in Western countries. The management of SCC still remains similar to that of transitional carcinoma, although it is a different entity. A retrospective review is helpful in understanding the epidemiologic aspects, pathogenesis, and treatment and prognosis of schistosoma-unrelated SCC.
Patients and methods: Between 1987 and 2002, 30 men and 3 women had been treated for pure SCC of the bladder, not related to bilharzias.
Results: The mean age of patients was 59 years (range, 29-83 years). They constitute 1.2% of all bladder tumors. At presentation, 2 patients had a distant metastasis. Eleven patients (34%) had a bladder stone with recurrent urinary tract infection; they had been treated since age 6-17 years. Twenty-one patients underwent radical cystectomy, followed by chemotherapy in 2 cases. At a mean follow-up of 5 years, 14 patients (66.6%) died of locoregional disease, with associated metastasis in 5 cases. Seven patients (33.3%) are alive without any evidence of disease. The survival rate was correlated with tumor stage.
Conclusion: The unrelated SCC has an unfavorable prognosis, mostly caused by the locally advanced disease at the time of presentation. Distant metastases are not rare. The transfer of novel chemotherapy regimens and preoperative radiation therapy should be considered because pelvic recurrences are the leading cause of progression in SCC.