Bladder transitional cell carcinoma anatomic primary site as a predictor of survival and mortality: a population-based retrospective cohort study.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL Annals of Medicine and Surgery Pub Date : 2024-09-18 eCollection Date: 2024-10-01 DOI:10.1097/MS9.0000000000002581
Ali Hemade, Souheil Hallit
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Abstract

Background: Bladder cancer is a heterogeneous disease with varying prognostic outcomes based on the primary tumor site within the bladder. This study aims to evaluate the impact of tumor location on overall survival and cancer-specific survival in bladder cancer patients.

Methods: The authors conducted a retrospective cohort study using data from the Surveillance, Epidemiology, and End Results database. Patients with primary transitional cell carcinoma of the bladder were categorized based on their tumor locations. Survival outcomes were assessed using Kaplan-Meier analysis and Cox proportional hazards regression models, adjusted for age, sex, race, cancer stage, and treatment modalities. Additionally, binary logistic regression models were employed to predict overall mortality (OM) and cancer-specific mortality (CSM) at 1, 5, and 10 years.

Results: The study included 107 909 patients diagnosed with primary bladder cancer between 2000 and 2021. Significant differences in survival outcomes were observed across different tumor sites. Bladder cancer originating in the urachus had the worst OS before 100 months and the worst CSS overall. Tumors in the anterior wall showed the worst OS after 100 months. In the Cox multivariable analysis, anterior wall tumors were associated with a 1.513-fold increased risk of death compared to lateral wall tumors. The binary logistic regression models showed that anterior wall tumors predicted the highest OM and CSM at 1-year, while urachal tumors had the worst outcomes at 5 and 10 years.

Conclusions: The primary site of bladder cancer is a significant predictor of survival outcomes, with tumors in the urachus and anterior wall associated with a poorer prognosis. These findings underscore the importance of considering tumor location in the prognosis and management of bladder cancer. Future studies should aim to validate these findings in more diverse populations and explore the underlying biological mechanisms that drive these differences.

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膀胱过渡细胞癌解剖学原发部位作为生存率和死亡率的预测因素:一项基于人群的回顾性队列研究。
背景:膀胱癌是一种异质性疾病,根据膀胱内原发肿瘤部位的不同,预后结果也不同。本研究旨在评估肿瘤位置对膀胱癌患者总生存期和癌症特异性生存期的影响:作者利用监测、流行病学和最终结果数据库中的数据进行了一项回顾性队列研究。根据肿瘤位置对原发性膀胱过渡细胞癌患者进行分类。采用卡普兰-梅耶分析和考克斯比例危险回归模型评估生存结果,并根据年龄、性别、种族、癌症分期和治疗方式进行调整。此外,还采用二元逻辑回归模型来预测1年、5年和10年的总死亡率(OM)和癌症特异性死亡率(CSM):研究纳入了 2000 年至 2021 年期间确诊的 107 909 例原发性膀胱癌患者。不同肿瘤部位的生存结果存在显著差异。原发于尿道的膀胱癌在100个月前的生存率最差,总体CSS最差。前壁肿瘤在 100 个月后的生存率最差。在Cox多变量分析中,与侧壁肿瘤相比,前壁肿瘤的死亡风险增加了1.513倍。二元逻辑回归模型显示,前壁肿瘤预测1年后的OM和CSM最高,而泌尿道肿瘤预测5年和10年后的结果最差:结论:膀胱癌的原发部位是预测生存结果的重要因素,尿道和前壁肿瘤的预后较差。这些发现强调了在膀胱癌的预后和治疗中考虑肿瘤位置的重要性。未来的研究应着眼于在更多样化的人群中验证这些发现,并探索导致这些差异的潜在生物机制。
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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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1665
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