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De Lorenzis E, Albo G, Longo F, Bebi C, Boeri L, Montanari E. Current Knowledge on Genomic Profiling of Upper Tract Urothelial Carcinoma. Genes (Basel) 2021; 12:genes12030333. [PMID: 33668859 PMCID: PMC7996334 DOI: 10.3390/genes12030333] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
Recent research in next-generation sequencing characterized the genomic landscape of urothelial cancer. However, the majority of the studies focused on bladder cancer (BC). Upper urinary tract urothelial carcinomas (UTUC) and BC share some histological characteristics, but, considering the differences in terms of embryologic precursors, epidemiology, genetics, medical and surgical management and response to therapy, UTUC and BC should be considered as two distinct diseases. Our objective is to analyze through a literature search the latest updates and the current knowledge about the genomics of UTUC. We also evaluate genetic differences between BC and UTUC and the potential implications for systemic therapy. Molecular subtyping and variant histology and their correlation with response to chemotherapy were also explored. In summary, the most frequent genomic variations in UTUC included FGFR3, chromatin remodeling genes, TP53/MDM2 and other tumor suppressors/oncogenes. The genomics of UTUC, integrated with clinical data, could drive the selection of patients who could benefit from targeted therapy or off-label treatment. Routine implementation of tumor genomic characterization in UTUC patients should therefore be contemplated and evaluated prospectively.
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Affiliation(s)
- Elisa De Lorenzis
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-55034546; Fax: +39-02-50320584
| | - Giancarlo Albo
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Fabrizio Longo
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
| | - Carolina Bebi
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- University of Milan, 20122 Milan, Italy
| | - Luca Boeri
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- University of Milan, 20122 Milan, Italy
| | - Emanuele Montanari
- Urology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (G.A.); (F.L.); (C.B.); (L.B.); (E.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Attia A, Siriwardana A, Desai D. Sarcomatoid urothelial carcinoma of the ureter with heterologous elements of chondrosarcoma and osteosarcoma, and concurrent divergent squamous differentiation: A rare case report. Urol Case Rep 2020; 34:101484. [PMID: 33224730 PMCID: PMC7662845 DOI: 10.1016/j.eucr.2020.101484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/01/2020] [Accepted: 11/03/2020] [Indexed: 11/04/2022] Open
Abstract
Primary sarcomatoid urothelial carcinoma of the ureter with heterologous elements is rare and carries a poor prognosis. Although there is some literature on primary bladder sarcomatoid urothelial carcinoma, ureteric involvement has been reported infrequently, and this case report describes this unusual histological finding with concurrent divergent squamous differentiation. Despite laparoscopic radical nephroureterectomy, our patient died within six months of diagnosis with local recurrence and metastatic spread. A more thorough understanding of this disease process and consideration of standardised guidelines for treatment are needed to improve patient outcomes.
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Affiliation(s)
- Arsany Attia
- Department of Urology, Ipswich Hospital, Ipswich, Queensland, Australia, 4305
| | - Amila Siriwardana
- Department of Urology, Ipswich Hospital, Ipswich, Queensland, Australia, 4305
| | - Devang Desai
- Department of Urology, Toowoomba Hospital, Toowoomba, Queensland, Australia, 4350.,Faculty of Medicine, Griffith University, Mount Gravatt, Queensland, Australia, 4122.,Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia, 4006.,Toowoomba Urology, Toowoomba, Queensland, Australia, 4350
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Cimadamore A, Scarpelli M, Santoni M, Cheng L, Lopez-Beltran A, Montironi R. Upper urinary tract urothelial carcinoma and its variants: transition from morphology to personalized molecular characterization in diagnosis, prognosis, and therapy. Expert Rev Mol Diagn 2018; 18:1021-1028. [PMID: 30452305 DOI: 10.1080/14737159.2018.1549490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Upper tract urothelial carcinoma (UTUC) accounts for 5% of urothelial carcinomas (UCs), the estimated annual incidence being 1-2 cases per 100,000 inhabitants. The aim of this review was to summarize the main morphologic features of UTUC as well as the current status and future role of its molecular characterization in diagnosis, prognosis, and therapy. Areas covered: Several studies on the UTUCs have shown the diagnostic, prognostic, and therapeutic significance of standard pathological features, such as tumor stage, grade, and lymph node metastasis. Investigations have also identified novel factors, in particular, variant histologies, and molecular biomarkers. Based on these, predictive tools have been developed. Expert commentary: The morphology of the UTUC has been considered to be the same as that of Bladder Urothelial carcinoma (BUC). Molecular characterization studies, including genomics, have shown changes in UTUC occurring at differing frequencies in comparison with BUC, the former with unique molecular subtypes and different responses to treatment.
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Affiliation(s)
- Alessia Cimadamore
- a Section of Pathological Anatomy, School of Medicine, United Hospitals , Polytechnic University of the Marche Region , Ancona , Italy
| | - Marina Scarpelli
- a Section of Pathological Anatomy, School of Medicine, United Hospitals , Polytechnic University of the Marche Region , Ancona , Italy
| | | | - Liang Cheng
- c Department of Pathology and Laboratory Medicine , Indiana University School of Medicine , Indianapolis , IN , USA
| | | | - Rodolfo Montironi
- a Section of Pathological Anatomy, School of Medicine, United Hospitals , Polytechnic University of the Marche Region , Ancona , Italy
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Hesse AN, Fabricius W, Thomas CA, Gaindh R, Christman R, Selvam P, Prego M, Lewis G, Uvalic J, Bergeron D, Burns S, Sisson B, Kelly K, Rueter J, Reddi HV. Genomic Profiling of Two Histologically Distinct Rare Urothelial Cancers in a Clinical Setting to Identify Potential Therapeutic Options for Treatment and Management of Disease. Case Rep Oncol 2018; 11:196-205. [PMID: 29681821 PMCID: PMC5903146 DOI: 10.1159/000487882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 02/22/2018] [Indexed: 01/14/2023] Open
Abstract
Molecular profiling of urothelial cancers for therapeutic and prognostic potential has been very limited due to the absence of cancer-specific targeted therapies. We describe here 2 clinical cases with a histological diagnosis of an invasive sarcomatoid and a poorly differentiated carcinoma favoring urothelial with some neuroendocrine differentiation, two of the rarer types of urothelial cancers, which were evaluated for mutations in 212 genes for single-nucleotide variants and copy-number variants and 53 genes for fusions associated with solid tumors. In both cases, we identified variants in 2 genes, ARID1A and CDKN2A, indicative of the role of dysregulation of chromatin remodeling and cell cycle control as being common features of bladder cancer, consistent with the proposed model of tumorigenesis in these rare, highly aggressive pathological subtypes. The presence of a KRAS mutation in the poorly differentiated cancer and a TP53 mutation in the sarcomatoid tumor is indicative of a distinctive profile and adds a potential layer of molecular stratification to these rarer histological subtypes. We present a comparative analysis of the histological, clinical, and molecular profile of both cases and discuss the potential to delineate these tumors at the molecular level keeping in mind the possible therapeutic implications.
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Affiliation(s)
- Andrew N Hesse
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | | | | | | | - Robert Christman
- Department of Pathology, Maine Medical Center, Portland, Maine, USA
| | - Pavalan Selvam
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Matthew Prego
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Gregory Lewis
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Jasmina Uvalic
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Daniel Bergeron
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Shelbi Burns
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Bridgette Sisson
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Kevin Kelly
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - Jens Rueter
- The Maine Cancer Genomics Initiative, The Jackson Laboratory, Augusta, Maine, USA
| | - Honey V Reddi
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
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Wang Y, Liu H, Wang P. Primary sarcomatoid urothelial carcinoma of the ureter: a case report and review of the literature. World J Surg Oncol 2018; 16:77. [PMID: 29653574 PMCID: PMC5899376 DOI: 10.1186/s12957-018-1383-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/05/2018] [Indexed: 11/26/2022] Open
Abstract
Background Sarcomatoid urothelial carcinoma is a very dangerous malignant tumour derived from the epithelium. Primary sarcomatoid carcinoma of the ureter is extremely rare in clinical practice. The prognosis of this kind of disease is really poor, and there is still not a diagnosis standard in the world. Case presentation An 82-year-old female patient who had intermittent waist pain without any other symptoms, had diagnosed as urothelial cancer on computerised tomography urography. Considering the patient’s age and quality of life, we made a preserving kidneys resection of the local tumour. The tumour was composed of sarcomatous and carcinomatous elements, and immunohistochemical examination showed that tumour cells were positive for cytokeratin, epithelial membrane antigen, vimentin, and GATA3 markers. There were no complications after 1-hour surgery. After 3 months, there was no signs of recurrence and metastasis. Conclusion This case was a patient with sacomatoid urothelial carcinoma. Through a transurethral resection with laser, the patient recovered well, and there was no sign of any recurrence of the tumour after 3 months. With the development of technology and science, more and more cancerous patients’ living quality and survival rate were improved. Maybe it is essential for urologists and scientists to entirely understand the characteristics of the sarcomatoid urothelial carcinoma and make a better clinical guideline.
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Affiliation(s)
- Yixiang Wang
- Department of Urology, The Fourth Hospital Affiliated to China Medical University, Chongshan East street, Shenyang, Liaoning, 110032, People's Republic of China
| | - Hanchao Liu
- Department of Urology, The Fourth Hospital Affiliated to China Medical University, Chongshan East street, Shenyang, Liaoning, 110032, People's Republic of China
| | - Ping Wang
- Department of Urology, The Fourth Hospital Affiliated to China Medical University, Chongshan East street, Shenyang, Liaoning, 110032, People's Republic of China.
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