Table 1: A list of some of the reported cases of nested variant of urothelial carcinoma and their outcome.

PatientReferenceAge/sexPathologic stageAJCC stageTreatmentStatusFollow-upAssociated CUC (WHO/ISUP 1998)

1Lin et al. [7]90/FpT11CystectomyNED30No

2Lin et al. [7]73/FpT3bIIICystectomy + chemotherapyNED 5No

3Lin et al. [7]65/MpT2bIVCystectomy + chemotherapyAWM16Flat CIS

4Lin et al. [7]70/MpT3bIIICystectomy + chemotherapyAWM15Flat CIS

5Lin et al. [7]61/MpT3bIVCystectomy + chemotherapyNED19Flat CIS

6Lin et al. [7]80/MpT3bIIICystectomyNED27Flat CIS

7Lin et al. [7] 66/MpT1 ICystectomyNED22No

8Lin et al. [7] 53/MpT1 ICystectomyNED19No

9Lin et al. [7] 51/MpT2IVRadiotherapyDOD 3No

10Lin et al. [7] 59/MpT2a IICystectomyNED24No

11Lin et al. [7]42/F pT2a IICystectomyNED20No

12Lin et al. [7]75/MpT2a ITUR NED12Low-grade papillary UC

13Wang et al. [11]49/FG3pT4M1Partial cystectomy; en bloc resection of distal ileum, caecum; resection of transplanted pancreas; right salpingo-oophorectomy; repair of ileocolostomy anastomosis; chemotherapy DOD12 monthsPlus conventional high-grade TCC

14Tatsura et al. [12]70/MG3pT3b Nx M0>IIIBladder adherent and cystectomy abandoned; open bladder total layer biopsy + bilateral ureterocutaneostomy; chemotherapyAlive with disease12 monthsSmall tumour atypical cells positive for cytokeratin

15Terada [13]80/FpT1TURAlive with no tumour6 monthsAtypical cells forming nests and tubules in lamina propria without surface urothelial involvement

16 Terada [13]78/MpT1TURAlive with no tumour 15 monthsAtypical cells forming nests and tubules in lamina propria without surface urothelial involvement

17De Berardinis et al. [14]70/M pT2aN+TUR twice + BCG for initial conventional G3pT1b tumour and cystectomy + lymphadenectomy + chemotherapy for nested variant was started Alive 12 months after initial diagnosis of conventional urothelial carcinoma12 months after initial diagnosis and exact duration of follow-up after cystectomy not stated but patient just started on chemotherapy after cystectomy

18, 19, 20, 21, 22, 23, 24Cardillo et al. [15] 5 M
2 F
7 cases
Age range 53–90 years
3 stage 1;
2 stage II;
1 stage III;
1 stage IV with metastasis
6 patients with stages I to III tumours underwent cystectomy;
1 patient with stage IV tumour had radiotherapy
Follow-up outcome data not providedFollow-up outcome data not provided in paper

25Dundar et al. [16]78/MpT4N1Cystoprostatectomy and chemotherapy planned but not given at time of publicationAliveFollow-up data not available at time of publication

26Dundar et al. [16]56/MpT2 at leastTURBT he refused radical cystoprostatectomyAlive but had 3 recurrences of nested variant urothelial carcinoma resected over 23 months23 months

27Badoual et al. [17]Details not availableDetails not available in EnglishDetails not availableDetails not available to authorDetails not availableDetails not available Details not available

28Badoual et al. [17]Details not available Details not availableDetails not available Details not available Details not available Details not available Details not available

29Krishnamoorthy et al. [18]45 FpT1TURAliveNo follow-up paper soon after TUR

30Ozdemir et al. [19] 65 MpT2 at leastTUR biopsy
Further details of treatment not mentioned in paper
Alive no data provided on follow-up case reported after biopsyData not available

31 Holmäng and Johansson 2001 [20] 10 patientsDetails not available to authorDetails not available to author 7 died of disease or treatment complications (4 months–40 months); 1 died of unrelated cause after 90 months; follow-up ≤1 year for the remaining 2

32Ooi et al. [21]74/MBladder tumour with ureteric involvementTUR + bilateral local resection of ureter and chemotherapyAlive with tumour (partial response)12 months

33–86Linder et al. [22]52 patients
Mean age 69.5 years
Range 62–74
36 (69%) with pT3-T4
10 (19%) with nodal invasion
All had radical cystectomy
8 had additional perioperative (15%) chemotherapy
Analysis in the comparison of patients with nested variant matched with a cohort of conventional urothelial carcinoma showed no significant differences in the 10-year local recurrence free survival (83% versus 80%, ) or 10-year cancer specific survival (41% versus 46%, )Median follow-up 10.8 months
Range 9.3–11.3

87Tripodi et al. [23]49/F Renal pelvis pT1Nephrectomy and upper ureterectomyAliveNo long-term follow-up at time of publication

88Cerda et al. [24]53/MpT3b pN1TUR and radical cystoprostatectomy, radiotherapy, and chemotherapyDied due to advanced metastatic disease 12 months

89Cerda et al. [24]83/FpT2TUR (surgical procedure not done due to advanced age)Died of disease3 years (36 months)

90 Yildiz et al. [25]60/MT2 at least (muscle invasion)TUR further details in Turkish languageNot found in data

91 Pusztaszeri et al. [26] Renal pelvis and ureterDetails not available to authorDetails not available to author Details not available to author

92Lau [27]Renal pelvisLocally advancedDetails not available to authorDetails not available to authorDetails not available to author

93Stern [1]45/MDetails not available to author Details not available to author TURAlive tumour recurred 18 months later18 months

94, 95, 96Talbert and Young [3]3 men
Aged 53–73 years
Details not available to author Details not available to author Details not available to author

97, 98, 99, 100Murphy and Deana [4]4 cases Details not available to authorDetails not available to authorDetails not available to author Tumours persisted/recurredDetails not available to author

101–130Wasco et al. [8]30 cases
Aged 41–83 years
Average 63
Male-female 2.3 : 1
All but 1 invasive tumours (9% pT1; pT2-3a; 65% pT3b; 17% pT4) All had cystectomy and 15 had cystectomy and chemotherapy3 (10%) died of disease; 16 (55%) alive with persistent or recurrent disease; 10 (34%) alive without disease
Response to chemotherapy observed in 2 (13%) of 15 patients
Follow-up in 29 patients (97%) with median 12 months (range 1–31 months)Focal atypia in 90% and focal high-grade cytological atypia at tumour base in 40%

131–134Young and Oliva [9]4 patients
Age range 70–85 years
Details not available to authorDetails not available to authorDetails not available to author1 or more specimens were misinterpreted as benign

135–150Drew et al. [10]16 cases with marked male predominanceDetails not available to author Details not available to author 3 with no diseaseAverage follow-up 16.6 monthsA few cells in every case with cytological atypia

151 and
152
Xiao et al. [28]69/M
70/M
pT4 N1
pT2/3 + perineural and vascular invasion + Gleason 3 + 3 adenoca of prostate
Radical cystoprostatectomy and chemotherapy
Radical cystoprostatectomy
Developed bone and soft tissue metastases in 4 months4 months
Lost to follow-up at 2 months
Focal urothelial CIS and multiple foci of urothelial atypia
Focus of urothelial CIS

153Huang et al. [29] 83/MG3pT2-3CystoprostatectomyAlive no long-term follow-up data available to author

154–164Volmar et al. [30]11 patients5 pT2-3 N0
1 pT2-3 M1;
1 pT4 stage of remaining not available to author
Details not available to authorDetails not available

165–174 Holmäng and Johansson [20]10 patients Details not availableLocoregional therapy7 died of disease or treatment complications 4–40 months after diagnosis;
1 died of unrelated cause after 90 months;
Follow-up ≤1 year for the remaining 2

175–177Liedberg et al. [31] 3 patientsAdvanced muscle-invasive 2 with lymph node involvementFinal outcome not available

178–200Cox and Epstein [32]23 cases
Mean age 63.7 years;
Range 39–89;
86% male
20 T2-T3
2 pT1
1a pT1b
18 had TURBT
2 nephroureterectomy
3 radical cystectomy
3 of 17 patients developed metastasis 2 lung 1 unknown with 2 of the 3 dead of disease; 1 patient died of disease with no known details
Follow-up for 17 patients
Mean 43 months
Range 5 months to 9 years

Abbreviations: M: male; F: female; NED: alive with no evidence of disease; AWM: alive with metastasis; DOD: dead of disease; CIS: carcinoma in situ; CUC: conventional urothelial carcinoma; TUR: transurethral resection of tumour; and Lin et al.: Lin O, Cardillo M, Dalbagni G, Linkov I, Hutchinson B, and Reuter V E. Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 12 cases. Modern Pathology 2003; 16(12): 1289-1298.