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Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer

  • Authors:
    • Alper Coskun
    • Ahmet Bilgehan Sahin
    • Selva Kabul
    • Mehmet Emin Dagtekin
    • Seda Sali
    • Buket Erkan Ozmarasali
    • Adem Deligonul
    • Erdem Cubukcu
    • Meral Kurt
    • Gursel Savci
    • Turkkan Evrensel
    • Ismet Yavascaoglu
  • View Affiliations / Copyright

    Affiliations: Department of Medical Oncology, Faculty of Medicine, Uludag University, 16059 Bursa, Turkey, Department of Pathology, Faculty of Medicine, Uludag University, 16059 Bursa, Turkey, Department of Internal Medicine, Faculty of Medicine, Uludag University, 16059 Bursa, Turkey, Department of Radiation Oncology, Faculty of Medicine, Uludag University, 16059 Bursa, Turkey, Department of Radiology, Faculty of Medicine, Uludag University, 16059 Bursa, Turkey, Department of Urology, Faculty of Medicine, Uludag University, 16059 Bursa, Turkey
    Copyright: © Coskun et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 299
    |
    Published online on: May 18, 2026
       https://doi.org/10.3892/ol.2026.15654
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Abstract

Bladder cancer is the ninth most common malignancy worldwide, with urothelial carcinoma (UC) representing the predominant histopathological subtype. UC may present as pure urothelial carcinoma (PUC), or alongside other variant histologies (VHs), with squamous differentiation in UC (SD) being the most frequently observed variant. The present study provides a population‑based insight into the survival outcomes of patients with SD compared with PUC in early‑stage disease. The present retrospective, observational study analyzed pathology reports from all cystectomies (n=632) performed at Uludag University Faculty of Medicine (Bursa, Turkey) between December 2010 and December 2023. A total of 23 patients with SD and 45 patients with PUC were evaluated; all of the patients had pathological stage T2N0 (pT2N0). The median follow‑up period was 5.27 years (range, 0.23‑16.60). Kaplan‑Meier survival analysis demonstrated no statistically significant difference in disease‑free survival (DFS) or overall survival (OS) between the SD and PUC groups. Univariate Cox regression analysis identified that age at diagnosis was a potential prognostic factor of both DFS and OS. The findings suggest that SD does not significantly affect DFS or OS in patients with pT2N0 UC. However, further prospective, multicenter, large‑scale studies are warranted to validate and expand upon these findings.
View Figures

Figure 1

Study flow diagram of patient
selection and histopathological re-evaluation. A total of 632
patients who underwent cystectomy were screened, of whom 115
patients with pT2N0 UC were identified based on initial pathology
reports. After applying predefined exclusion criteria (including
neoadjuvant CT, stage IV disease, missing data, concurrent VHs and
early postoperative mortality), 69 patients underwent
histopathological re-evaluation. Following re-evaluation, 23
patients were classified as having SD and 45 as PUC; one patient
with a non-squamous VH was excluded. pT2N0, pathological stage
T2N0; UC, urothelial carcinoma; VH, variant histology; SD, squamous
differentiation in urothelial carcinoma; PUC, pure urothelial
carcinoma.

Figure 2

Kaplan-Meier curve for disease-free
survival according to histopathological subtype.(SD vs. PUC;
log-rank P=0.998). SD, squamous differentiation in urothelial
carcinoma; PUC, pure urothelial carcinoma; HR, hazard ratio; CI,
confidence interval.

Figure 3

Kaplan-Meier curve for overall
survival according to histopathological subtype (SD vs. PUC;
log-rank P=0.795). SD, squamous differentiation in urothelial
carcinoma; PUC, pure urothelial carcinoma; HR, hazard ratio; CI,
confidence interval.
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Copy and paste a formatted citation
Spandidos Publications style
Coskun A, Sahin AB, Kabul S, Dagtekin ME, Sali S, Ozmarasali BE, Deligonul A, Cubukcu E, Kurt M, Savci G, Savci G, et al: Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer. Oncol Lett 32: 299, 2026.
APA
Coskun, A., Sahin, A.B., Kabul, S., Dagtekin, M.E., Sali, S., Ozmarasali, B.E. ... Yavascaoglu, I. (2026). Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer. Oncology Letters, 32, 299. https://doi.org/10.3892/ol.2026.15654
MLA
Coskun, A., Sahin, A. B., Kabul, S., Dagtekin, M. E., Sali, S., Ozmarasali, B. E., Deligonul, A., Cubukcu, E., Kurt, M., Savci, G., Evrensel, T., Yavascaoglu, I."Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer". Oncology Letters 32.1 (2026): 299.
Chicago
Coskun, A., Sahin, A. B., Kabul, S., Dagtekin, M. E., Sali, S., Ozmarasali, B. E., Deligonul, A., Cubukcu, E., Kurt, M., Savci, G., Evrensel, T., Yavascaoglu, I."Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer". Oncology Letters 32, no. 1 (2026): 299. https://doi.org/10.3892/ol.2026.15654
Copy and paste a formatted citation
x
Spandidos Publications style
Coskun A, Sahin AB, Kabul S, Dagtekin ME, Sali S, Ozmarasali BE, Deligonul A, Cubukcu E, Kurt M, Savci G, Savci G, et al: Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer. Oncol Lett 32: 299, 2026.
APA
Coskun, A., Sahin, A.B., Kabul, S., Dagtekin, M.E., Sali, S., Ozmarasali, B.E. ... Yavascaoglu, I. (2026). Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer. Oncology Letters, 32, 299. https://doi.org/10.3892/ol.2026.15654
MLA
Coskun, A., Sahin, A. B., Kabul, S., Dagtekin, M. E., Sali, S., Ozmarasali, B. E., Deligonul, A., Cubukcu, E., Kurt, M., Savci, G., Evrensel, T., Yavascaoglu, I."Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer". Oncology Letters 32.1 (2026): 299.
Chicago
Coskun, A., Sahin, A. B., Kabul, S., Dagtekin, M. E., Sali, S., Ozmarasali, B. E., Deligonul, A., Cubukcu, E., Kurt, M., Savci, G., Evrensel, T., Yavascaoglu, I."Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer". Oncology Letters 32, no. 1 (2026): 299. https://doi.org/10.3892/ol.2026.15654
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