2ⁿᵈ Edition of the Cancer R&D World Conference 2026

Abstract

Background: Pure squamous cell carcinoma (SqCC) of the bladder is rare and there is no consensus on optimal therapy in the metastatic setting. Oncologic principles suggest that surgery in the setting of progressive metastatic disease despite systemic therapy is unlikely to lead to cure. We present a case of a patient with progressive lung metastases despite best systemic therapy who underwent bilobectomy with durable disease control since.

Case: A 65-year-old female underwent radical cystectomy and was found to have SqCC (pT3bN0). Her post-operative scans showed two lung metastases. She had disease growth despite  platinum chemotherapy and immunotherapy and hospice was considered given her declining performance status. She underwent a pulmonary bilobectomy and mediastinal lymphadenectomy which showed SqCC and 1 of 19 lymph nodes involved. This resulted in a durable complete response 20 months later.

Discussion: This case demonstrates the efficacy of surgical intervention to a metastatic site in a rare disease that was both rapidly metastatic after cystectomy and unresponsive to systemic therapy. This contradicts the traditional oncologic principles concerning the high potential for micrometastatic disease during times of gross radiographic progression. The bilobectomy was pursued with palliative intent and yet has provided her with a complete response for the last 20 months.  

Conclusion: Surgical resection for metastatic disease in pure SqCC of the bladder in patients with rapid relapse after cystectomy and primary resistance to systemic therapy may be a viable approach to disease management on a case-by-case basis.