Management of the Uncommon Bladder Cancers: A Single-Center Experience over 10 Years.

IF 1.8 Q3 UROLOGY & NEPHROLOGY Advances in Urology Pub Date : 2020-10-07 eCollection Date: 2020-01-01 DOI:10.1155/2020/7563703
Youssef Kadouri, Salim Lachkar, Hamza Dergamoun, Hachem El Sayegh, Lounis Benslimane, Yassine Nouini
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引用次数: 1

Abstract

Background: Under the name of uncommon bladder cancers are gathered rare histological entities which represent less than 5% of bladder tumors. There is not a clear and consensual therapeutic management for these entities.

Purpose: To review a single-institution 10-year experience with rare form of bladder cancers detailing the diagnosis, treatment, and patient outcome.

Materials and methods: We performed a retrospective review of 27 medical records of rare bladder cancer form treated at our center between February 2006 and February 2015. The clinicopathologic features are reported with emphasis on treatment and survival.

Results: Mean patient age was 65.5 ± 20 yr and 70% of patients were males. Smoking background was found in 16 cases, chronic bladder irritation factors were found in 12 cases, and past urinary tract infection was found in 11 cases. The main symptom was total hematuria (93%) causing an anemia in 16 cases. The two mean histological forms were epidermoid carcinoma (37%) and adenocarcinoma (22%). 26% of patients were found to have extended invasive tumors (T4) at diagnosis. Metastatic disease was confirmed in 8 cases. Our patients were managed by a wide range of therapeutic modalities as total cystectomy with bilateral lymph node dissection (63%), palliative chemotherapy (30%), or concomitant radiochemotherapy (7%). 55.6% of patients were alive one year after diagnosis. Epidermoid carcinoma has the best prognosis followed by leiomyosarcoma and sarcomatoid carcinoma. Neuroendocrine carcinoma has the worst outcome. The overall 5-year survival rate is 33.3%.

Conclusion: The rarity and small size of these tumors justify the absence of clear and consensual therapeutic management. No role of total cystectomy concerning the conclusions could be drawn but elements suggest this may be the treatment of choice. The highly aggressive nature of those lesions justifies an aggressive and fast therapy when feasible which gives the best outcomes.

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罕见膀胱癌的治疗:10年来的单中心经验。
背景:罕见膀胱癌是一种罕见的组织学实体,占膀胱肿瘤的不到5%。对于这些实体,没有明确和双方同意的治疗管理。目的:回顾一份单机构10年罕见膀胱癌的详细诊断、治疗和患者预后。材料与方法:回顾性分析2006年2月至2015年2月在我中心治疗的27例罕见膀胱癌病例。临床病理特征的报告,重点是治疗和生存。结果:患者平均年龄为65.5±20岁,男性占70%。吸烟背景16例,慢性膀胱刺激因素12例,既往尿路感染11例。16例以总血尿为主(93%),并发贫血。两种平均组织学形式为表皮样癌(37%)和腺癌(22%)。26%的患者在诊断时发现扩展浸润性肿瘤(T4)。8例确诊为转移性疾病。我们的患者接受了广泛的治疗方式,如全膀胱切除术加双侧淋巴结清扫(63%)、姑息性化疗(30%)或联合放化疗(7%)。55.6%的患者在诊断后1年存活。表皮样癌预后最好,其次为平滑肌肉瘤和肉瘤样癌。神经内分泌癌的预后最差。总体5年生存率为33.3%。结论:这些肿瘤罕见且体积小,因此缺乏明确和双方同意的治疗管理。没有全膀胱切除术对结论的影响,但一些因素表明这可能是治疗的选择。这些病变具有很强的侵袭性,因此在可行的情况下采取积极和快速的治疗,以获得最佳效果。
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来源期刊
Advances in Urology
Advances in Urology UROLOGY & NEPHROLOGY-
CiteScore
2.90
自引率
0.00%
发文量
17
审稿时长
15 weeks
期刊介绍: Advances in Urology is a peer-reviewed, open access journal that publishes state-of-the-art reviews and original research papers of wide interest in all fields of urology. The journal strives to provide publication of important manuscripts to the widest possible audience worldwide, without the constraints of expensive, hard-to-access, traditional bound journals. Advances in Urology is designed to improve publication access of both well-established urologic scientists and less well-established writers, by allowing interested scientists worldwide to participate fully.
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