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Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jul 24, 2024; 15(7): 835-839
Published online Jul 24, 2024. doi: 10.5306/wjco.v15.i7.835
Histologic subtypes of non-muscle invasive bladder cancer
Nicola Giudici, Roland Seiler
Nicola Giudici, Roland Seiler, Department of Urology, Spitalzentrum Biel, Biel 2501, Switzerland
Roland Seiler, Department of BioMedical Research, University of Bern, Bern 3010, Switzerland
Author contributions: Giudici N performed the majority of the writing and prepared the tables; Seiler R provided input and supervision in writing the paper; Both authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nicola Giudici, MD, Doctor, Department of Urology, Spitalzentrum Biel, Vogelsang 84, Biel 2501, Switzerland. nicolagiudici@gmail.com
Received: March 28, 2024
Revised: May 21, 2024
Accepted: May 30, 2024
Published online: July 24, 2024
Processing time: 109 Days and 17.4 Hours
Abstract

The majority of bladder cancers (BCs) are non-muscle invasive BCs (NMIBCs) and show the morphology of a conventional urothelial carcinoma (UC). Aberrant morphology is rare but can be observed. The classification and characterization of histologic subtypes (HS) in UC in BC have mainly been described in muscle invasive bladder cancer (MIBC). However, the currently used classification is applied for invasive urothelial neoplasm and therefore, also valid for a subset of NMIBC. The standard transurethral diagnostic work-up misses the presence of HS in NMIBC in a considerable percentage of patients and the real prevalence is not known. HS in NMIBC are associated with an aggressive phenotype. Consequently, clinical guidelines categorize HS of NMIBC as ”(very) high-risk” tumors and recommend offering radical cystectomy to these patients. Alternative strategies for bladder preservation can only be offered to highly selected patients and ideally within clinical trials. Novel treatment strategies and biomarkers have been established MIBC and NMIBC but have not been comprehensively investigated in the context of HS in NMIBC. Further evaluation prior to implementation into clinical practice is needed.

Keywords: Urothelial carcinoma, Non-muscle invasive bladder cancer, Muscle invasive bladder cancer, Histologic subtypes, Histologic variants

Core Tip: The currently used classification for histologic subtypes (HS) in urothelial carcinoma has mainly been described in muscle invasive bladder cancer. However, a subset of non-muscle invasive bladder cancer presents HS, and their presence is clinically relevant. In this minireview, we discuss the epidemiology, classification, characterization and the clinical relevance of HS in non-muscle invasive bladder cancer.