Table 3. Studies on plasmacytoid UC reporting outcomes with either neoadjuvant chemotherapy or upfront radical cystectomy.

Author (year)	Pathologic complete response	Pathologic downstaging	Median follow up after cystectomy	Survival outcomes after cystectomy	Major independent factor(s) other than histologic phenotype affecting response/outcomes analyzed	Comments
Li (7) (2019), n=1,410 (VH n=98) (45 patients with plasmacytoid variant received, NAC and 41 patients did not)		Regardless of receipt of NAC, 22% (95% CI: 14–32%) of patients who had a clinical stage ≥ cT2 were down staged to pT1 on RC	5 years for plasmacytoid group. 7.6 years for conventional UC group	Median OS for plasmacytoid histology vs. conventional UC was 3.8 and 8 yr respectively. Plasmacytoid histology was associated with increased overall mortality on univariable analysis (HR=1.34, 95% CI: 1.02–1.78; P=0.039) but not on multivariable analysis		17.6% of patients developed peritoneal carcinomatosis on median follow up of 4.6 years
Kaimakliotis (28) (2014), n=308 (VH n=30)			30 months	UC with plasmacytoid VH had significantly inferior OS outcomes. Median OS for plasmacytoid VH patients was 19 months, median OS for conventional UC patients had not been reached at 68 months		Plasmacytoid VH at cystectomy was associated with increased adjusted risk of mortality (HR 2.1; 95% CI: 1.2-3.8; P=0.016)

UC, urothelial carcinoma; VH, variant histology; NAC, neoadjuvant chemotherapy; RC, radical cystectomy; CSS, cancer specific survival; OS, overall survival.