Objective:To examine the diagnostic and therapeutic approaches utilized for sarcomatoid carcinoma of the bladder,with the aim of enhancing the clinical management and treatment outcomes for patients afflicted with this particular disease.Methods:The clinical data of 5 patients with primary sarcomatoid carcinoma of the bladder admitted to Xuzhou Central Hospital from February 2010 to January 2021 were retrospectively analyzed.The patients were all male,with an average age of 78 years old.Four cases underwent laparoscopic radical cystec-tomy for bladder cancer and 1 case underwent partial cystectomy.One of the total resection patients underwent preoperative and postoperative gemcitabine+nedaplatin intravenous chemotherapy,and the partial resection pa-tient underwent postoperative gemcitabine bladder instillation.Results:Postoperative pathology confirmed the di-agnosis of sarcomatoid carcinoma of the bladder in all 5 patients.After 6-37 months of postoperative follow-up,4 cases died and 1 case survived.Two of them developed postoperative lymph node or intestinal metastases.A-mong the patients with total resection,there were 2 cases of stage T1N0M0,1 case of stage T2N0M0,1 case of stage T3N0M0,and the patient with partial cystotomy was staged as T2N0M0.Immunohistochemistry showed that both Vim and CK were positive.Conclusion:Sarcomatoid carcinoma of the bladder is an infrequent occurrence in clinical practice,sharing clinical manifestations akin to typical uroepithelial carcinoma.Its diagnosis poses chal-lenges,and the majority of cases exhibit an unfavorable prognosis due to early detection being hindered by muscu-lar infiltration,a high level of malignancy,and a tendency for recurrence and metastasis.Surgical intervention serves as the primary treatment modality for sarcomatoid carcinoma,offering the potential to enhance patient sur-vival rates when combined with postoperative chemotherapy and other supplementary approaches.
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