The prognostic value of histological subtype in patients with metastatic bladder cancer

Abstract

We aim to evaluate the prognostic effect of the histological sub-type in patients with metastatic bladder cancer based on the Surveillance Epidemiology and End Results database. A total of 2634 eligible patients were included. The histological subtypes were: transitional cell carcinoma (TCC; 75.2%); adenocarcinoma (3.3%); squamous cell carcinoma (SQCC; 4.1%); and small cell carcinoma (4.3%). A significant association of adenocarcinoma with better survival outcomes (P < 0.015), and that of SQCC with worse outcomes (P < 0.001) was observed. On multivariate analysis, adenocarcinoma was significantly associated with longer and SQCC with shorter survival time as compared to TCC. Overall, 1331 (50.5%) patients had a single metastatic site and 523 (19.9%) had multiple sites involved. Single-site metastasis had a better survival outcome than multiple metastases (P < 0.001). Histological sub-type and presence of multiple metastatic sites are independent predictors of survival time. Prospective, in-depth research is needed to determine optimal therapeutic strategies for different histological subtypes of bladder cancer with different metastatic patterns.

Prognostic value of site-specific metastases and therapeutic roles of surgery for patients with metastatic bladder cancer: a population-based study

“… 34 Besides, Chen et al also suggested that the surgeries might improve patients’ OS outcomes. 9 Our study, for the first time, pointed out that patients with single metastatic site rather than multiple metastatic sites could benefit from RC, and that the RC was an independent prognostic predictor for metastatic BCa patients. Furthermore, this benefit could also be observed in patients with bone-only metastasis.…”

“…Our findings were unexpectedly contradictory to the results of the previous study, in which the multisite metastases were found to be able to independently predict worse OS and CSS. 9 The difference might arise from the different choices of the covariates in the Cox model, and further studies are needed to expound how the number of metastatic sites could affect the prognosis of patients with metastatic BCa. We specially did subgroup analyses based on patients with a single-site metastasis and found that patients with distant node-only and liver-only metastases had the best and the most unfavorable survival outcomes, respectively.…”

“…Patients with different metastatic sites might represent different subgroups of patients with different tumor biologic patterns and prognosis and subsequently, distinct therapeutic approaches. 7 , 9 Previous studies had pointed out that liver metastases might be a predictor for poor prognosis in metastatic urothelial carcinoma patients. 10 – 12 Nevertheless, due to the limited number of patients and differences in treatment strategies, the effects of bone metastases, distant lymph node metastases as well as different sorts of visceral metastases on the prognosis of metastatic BCa patients remain blurry.…”

Racial differences in Urinary Bladder Cancer in the United States

“…UBC has many histological types. Transitional Cell Carcinoma (TCC) is the most common histological type of primary UBC, which comprises more than 90% of all bladder tumors 6 . Except for TCC, this article also considers two other histological types which are squamous cell carcinoma (SCC) and Carcinoma.…”

Bladder cancer stem cells: clonal origin and therapeutic perspectives

“…Bladder cancer is highly recurrent, metastatic and heterogenous, thereby resulting in poor prognosis [ 11 ]. It is postulated that bladder cancer stem cells are partly responsible for the clinical characteristics and complex biological behavior of bladder cancer [ 12 ].…”