Lymphoepithelioma-like, a variant of urothelial carcinoma of the urinary bladder

a case report and systematic review for optimal treatment modality for disease-free survival

Andy W. Yang, Aydin Pooli, Subodh M Lele, Ina W. Kim, Judson D. Davies, Chad A LaGrange

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Lymphoepithelioma-like carcinoma (LELC) is a rare high-grade carcinoma that resembles nasopharyngeal lymphoepithelioma and can occur throughout the body. First reported in 1991, bladder LELC has an incidence of about 1% of all bladder carcinomas. Due to its rare occurrence, prognoses and ideal treatment guidelines have not been clearly defined. Methods: A PubMed search was performed using two terms, "lymphoepithelioma-like carcinoma" and "bladder." Review articles, articles in foreign languages, expression studies, and studies not performed in the bladder were excluded. We report a case of LELC of the bladder including treatment and outcome and performed a systematic review of all 36 available English literatures from 1991 to 2016 including the present case to identify factors affecting disease-free survival. Results: One hundred forty cases of bladder LELC were analyzed. The mean age of the patients was 70.1 years ranging from 43 to 90 years with 72% males and 28% females. Pure LELC occurs most often at 46% followed by mixed LELC 28% and predominant LELC 26%. EBV testing was negative in all cases tested. Mean follow-up length for all cases was 33.8 months with no evidence of disease in 62.2%, while 11.1% died of disease, 10.4% alive with metastasis, and 8.2% died without disease. 5.0% of cases had recurrence at an average of 31.3 months. Prognosis is significantly favorable for patients presenting with pure or predominant forms of LELC compared to mixed type (p < 0.0001). The treatment significantly associated with the highest disease mortality and lowest disease-free survival was TURBT alone when compared to any multi-modality treatment (p < 0.01). Conclusion: We conclude that the best treatment modality associated with the highest disease-free survival is multi-modal treatment including radical cystectomy.

Original languageEnglish (US)
Article number34
JournalBMC Urology
Volume17
Issue number1
DOIs
StatePublished - Apr 27 2017

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Disease-Free Survival
Urinary Bladder
Carcinoma
Therapeutics
Literature
Cystectomy
Human Herpesvirus 4
PubMed
Language
Guidelines
Neoplasm Metastasis
Recurrence
Mortality
Incidence

Keywords

  • Bladder tumor
  • Case report
  • Lymphoepithelioma-like carcinoma
  • Systematic review

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

Cite this

Lymphoepithelioma-like, a variant of urothelial carcinoma of the urinary bladder : a case report and systematic review for optimal treatment modality for disease-free survival. / Yang, Andy W.; Pooli, Aydin; Lele, Subodh M; Kim, Ina W.; Davies, Judson D.; LaGrange, Chad A.

In: BMC Urology, Vol. 17, No. 1, 34, 27.04.2017.

Research output: Contribution to journalArticle

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abstract = "Background: Lymphoepithelioma-like carcinoma (LELC) is a rare high-grade carcinoma that resembles nasopharyngeal lymphoepithelioma and can occur throughout the body. First reported in 1991, bladder LELC has an incidence of about 1{\%} of all bladder carcinomas. Due to its rare occurrence, prognoses and ideal treatment guidelines have not been clearly defined. Methods: A PubMed search was performed using two terms, {"}lymphoepithelioma-like carcinoma{"} and {"}bladder.{"} Review articles, articles in foreign languages, expression studies, and studies not performed in the bladder were excluded. We report a case of LELC of the bladder including treatment and outcome and performed a systematic review of all 36 available English literatures from 1991 to 2016 including the present case to identify factors affecting disease-free survival. Results: One hundred forty cases of bladder LELC were analyzed. The mean age of the patients was 70.1 years ranging from 43 to 90 years with 72{\%} males and 28{\%} females. Pure LELC occurs most often at 46{\%} followed by mixed LELC 28{\%} and predominant LELC 26{\%}. EBV testing was negative in all cases tested. Mean follow-up length for all cases was 33.8 months with no evidence of disease in 62.2{\%}, while 11.1{\%} died of disease, 10.4{\%} alive with metastasis, and 8.2{\%} died without disease. 5.0{\%} of cases had recurrence at an average of 31.3 months. Prognosis is significantly favorable for patients presenting with pure or predominant forms of LELC compared to mixed type (p < 0.0001). The treatment significantly associated with the highest disease mortality and lowest disease-free survival was TURBT alone when compared to any multi-modality treatment (p < 0.01). Conclusion: We conclude that the best treatment modality associated with the highest disease-free survival is multi-modal treatment including radical cystectomy.",
keywords = "Bladder tumor, Case report, Lymphoepithelioma-like carcinoma, Systematic review",
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T2 - a case report and systematic review for optimal treatment modality for disease-free survival

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AU - Pooli, Aydin

AU - Lele, Subodh M

AU - Kim, Ina W.

AU - Davies, Judson D.

AU - LaGrange, Chad A

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N2 - Background: Lymphoepithelioma-like carcinoma (LELC) is a rare high-grade carcinoma that resembles nasopharyngeal lymphoepithelioma and can occur throughout the body. First reported in 1991, bladder LELC has an incidence of about 1% of all bladder carcinomas. Due to its rare occurrence, prognoses and ideal treatment guidelines have not been clearly defined. Methods: A PubMed search was performed using two terms, "lymphoepithelioma-like carcinoma" and "bladder." Review articles, articles in foreign languages, expression studies, and studies not performed in the bladder were excluded. We report a case of LELC of the bladder including treatment and outcome and performed a systematic review of all 36 available English literatures from 1991 to 2016 including the present case to identify factors affecting disease-free survival. Results: One hundred forty cases of bladder LELC were analyzed. The mean age of the patients was 70.1 years ranging from 43 to 90 years with 72% males and 28% females. Pure LELC occurs most often at 46% followed by mixed LELC 28% and predominant LELC 26%. EBV testing was negative in all cases tested. Mean follow-up length for all cases was 33.8 months with no evidence of disease in 62.2%, while 11.1% died of disease, 10.4% alive with metastasis, and 8.2% died without disease. 5.0% of cases had recurrence at an average of 31.3 months. Prognosis is significantly favorable for patients presenting with pure or predominant forms of LELC compared to mixed type (p < 0.0001). The treatment significantly associated with the highest disease mortality and lowest disease-free survival was TURBT alone when compared to any multi-modality treatment (p < 0.01). Conclusion: We conclude that the best treatment modality associated with the highest disease-free survival is multi-modal treatment including radical cystectomy.

AB - Background: Lymphoepithelioma-like carcinoma (LELC) is a rare high-grade carcinoma that resembles nasopharyngeal lymphoepithelioma and can occur throughout the body. First reported in 1991, bladder LELC has an incidence of about 1% of all bladder carcinomas. Due to its rare occurrence, prognoses and ideal treatment guidelines have not been clearly defined. Methods: A PubMed search was performed using two terms, "lymphoepithelioma-like carcinoma" and "bladder." Review articles, articles in foreign languages, expression studies, and studies not performed in the bladder were excluded. We report a case of LELC of the bladder including treatment and outcome and performed a systematic review of all 36 available English literatures from 1991 to 2016 including the present case to identify factors affecting disease-free survival. Results: One hundred forty cases of bladder LELC were analyzed. The mean age of the patients was 70.1 years ranging from 43 to 90 years with 72% males and 28% females. Pure LELC occurs most often at 46% followed by mixed LELC 28% and predominant LELC 26%. EBV testing was negative in all cases tested. Mean follow-up length for all cases was 33.8 months with no evidence of disease in 62.2%, while 11.1% died of disease, 10.4% alive with metastasis, and 8.2% died without disease. 5.0% of cases had recurrence at an average of 31.3 months. Prognosis is significantly favorable for patients presenting with pure or predominant forms of LELC compared to mixed type (p < 0.0001). The treatment significantly associated with the highest disease mortality and lowest disease-free survival was TURBT alone when compared to any multi-modality treatment (p < 0.01). Conclusion: We conclude that the best treatment modality associated with the highest disease-free survival is multi-modal treatment including radical cystectomy.

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KW - Systematic review

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