The natural history, treatment pattern, and survival of the patients with micropapillary bladder.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15015-e15015
Author(s):  
Jue Wang
Keyword(s):  
Natural History ◽  
Tumor Stage ◽  
Invasive Disease ◽  
Population Based ◽  
Bladder Tumors ◽  
Cancer Specific Survival ◽  
Undifferentiated Histology ◽  
Primary Bladder ◽  
Muscle Invasive ◽  
Population Based Registry

e15015 Background: Micropapillary bladder carcinoma (MPBC) is a rare variant of urothelial carcinoma. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of MPBC using population-based registry. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases of MPBC by tumor site and histology codes. The clinical, demographic characteristics, treatment and survival of MPBC were examined. Results: A total of 98 cases of histology confirmed MPBC were identified between 2001 and 2007, this accounted for approximately 0.01% of all primary bladder tumors during the study period. Median age of the patients was 72 years (range 26-95). Of all the patients with MPBC, 56.1% had muscle invasive disease; 75.5% of patients had poorly or undifferentiated histology. A total of 30.6% of all patients (2.3% superficial disease; 52.7% of muscle-invasive MPBC) had radical or partial cystectomy. By logistic regression analysis, nonmuscle-invasive MPBC (OR 62.5, 95% CI 7.2-542.3) was associated with lower rate of utilization of cystectomy. The 1-, 3- and 5-year overall survival rate of MPBC were 84.5%, 57.3% and 42.3%. In multivariate analysis, tumor stage (HR 4.7, 95% CI 1.0-21.8) was found to be the only significant predictor for cancer-specific survival. Conclusions: The optimal therapy for MPBC remains undermined. Emphasis on early detection is needed to improve the outcome for patients with this malignancy.

scholarly journals The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Jue Wang ◽  
Fen Wei Wang ◽  
Anne Kessinger
Keyword(s):  
Natural History ◽  
Renal Pelvis ◽  
Histological Grade ◽  
Tumor Stage ◽  
Population Based ◽  
Age At Diagnosis ◽  
Cancer Specific Survival ◽  
Entire Cohort ◽  
Undifferentiated Histology ◽  
Almost All

Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP) using population-based registry.Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER) database and reviewed.Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4–9). The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK) or renal pelvis (CSP). In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival.Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location.

scholarly journals Clinical Features of Sarcomatoid Carcinoma (Carcinosarcoma) of the Urinary Bladder: Analysis of 221 Cases

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Jue Wang ◽  
Fen Wei Wang ◽  
Chad A. LaGrange ◽  
George P. Hemstreet III ◽  
Anne Kessinger
Keyword(s):  
Urinary Bladder ◽  
Sarcomatoid Carcinoma ◽  
Tumor Stage ◽  
Population Based ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Term Survival ◽  
Primary Tumors ◽  
Undifferentiated Histology ◽  
Primary Bladder

Background. Urinary bladder sarcomatoid carcinoma (carcinosarcoma) is rare. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of urinary bladder carcinosarcoma using population-based registry.Methods. The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined.Results. A total of 221 histology confirmed cases were identified between 1973 and 2004, this accounted for approximately 0.11% of all primary bladder tumors during the study period. Median age of the patients was 75 years (range 41–96). Of the patients with a known tumor stage , 72.5% had a regional or distant stage; 98.4% of patients with known histology grade , had poorly or undifferentiated histology. Multiple primary tumors were indentified in about 40% of study subjects. The majority of patients (95.9%) received cancer directed surgery, 35.8% had radical or partial cystectomy, 15.8% of patients received radiation therapy combination with surgery. The median overall survival was 14 months (95% CI 7–21 months). 1-, 5-, and 10-year cancer specific survival rate were 53.9%, 28.4% and 25.8%. In a multivariate analysis, only tumor stage was found to be a significant prognostic factor for disease-specific survival.Conclusions. Urinary bladder carcinosarcoma commonly presented as high grade, advanced stage and aggressive behavior with a poor prognosis. Emphasis on early detection, including identification of risk factors is needed to improve the outcome for patients with this malignancy.

Multiple primary tumors in patients with carcinosarcoma of bladder: A coincidence or an etiological association? A study of 221 carcinosarcoma of bladder cases

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16138-e16138
Author(s):  
J. Wang ◽  
F. Wang
Keyword(s):  
Prognostic Factors ◽  
Natural History ◽  
Tumor Stage ◽  
Population Based ◽  
Primary Tumors ◽  
Multiple Primary Tumors ◽  
Number Of Patients ◽  
Multiple Primary ◽  
Primary Bladder ◽  
Patient’S Outcome

e16138 Background: Carcinosarcoma of the bladder are rare; As a result, few studies of carcinosarcoma of the bladder have included sufficient number of patients to define their natural history and to determine the factors that impact survival. The objective of this study was to examine the epidemiology, natural history, and prognostic factors that affect the survival for carcinosarcoma of the bladder by using population-based registries. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database (1973–2004) was used to identify cases of carcinosarcoma of the bladder by tumor site and histology codes. The association between clinical and demographic characteristics and survival of carcinosarcoma of the bladder was examined. Results: A total of 221 cases of histology confirmed carcinosarcoma of the bladder were identified, this account for approximately 0.11% of primary bladder tumors during same period. By using linked population files, we calculated the incidence of carcinosarcoma of the bladder as a rate 0.22 per 100,000 per year, age-adjusted to year 2000 U.S. standard population. Median age of all patients were 75 years (range 41–96). In about 40% of study population, more than one or multiple primary were also indentified. Majority of (212, 95.9 %) patients received cancer directed surgery. For survival analyses, we excluded the cases that were identified at autopsy or on the basis of death certificates only and the patients have more than one primary. Total 132 patients were included in survival analysis. The median overall survival for all cases was 9 months (range 6–12 months). In multivariate analysis, only tumor stage was found to be significant prognostic factors for disease-specific survival. Conclusions: Carcinosarcoma of the bladder are rare tumors that are challenging, the survival is poor even in patients underwent surgical resection. Better therapy is needed to improve patient's outcome. A significant fraction of carcinosarcoma patients are actually affected by multiple primary tumors, the potential association between carcinosarcoma and other neoplasms remain to be investigated. No significant financial relationships to disclose.

scholarly journals Is there a gender effect in bladder cancer? A population-based study of practice and outcomes

2015 ◽  
Vol 9 (7-8) ◽  
pp. 269 ◽  
Author(s):  
Francis Michael Patafio ◽  
D. Robert Siemens ◽  
Xuejiao Wei ◽  
Christopher M. Booth
Keyword(s):  
Bladder Cancer ◽  
Invasive Disease ◽  
Population Based ◽  
Disease Treatment ◽  
Full Cohort ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Ontario Cancer Registry ◽  
Muscle Invasive ◽  
Extent Of Disease

Introduction: The incidence of bladder cancer varies by gender. Whether differences exist between women and men in extent of disease, treatment, and outcome is not well-described. We evaluate gender differences in bladder cancer using a population-based cohort.Methods: Electronic records of treatment were linked to the population- based Ontario Cancer Registry to identify all patients with bladder cancer treated with cystectomy or radical radiotherapy (RT) in Ontario between 1994 and 2008. We compare extent of disease at time of cystectomy, treatment, and outcomes between women and men.Results: In total, 5259 patients with bladder cancer were treated with cystectomy or radical RT; of these, 25% (n = 1296) were women. There was no gender difference in the proportion of patients treated with cystectomy (75% of women [974/1296], 73% of men [2905/3963], p = 0.189). At the time of cystectomy, women were more likely to have muscle-invasive disease (86% [836/974] vs. 80% [2335/2905], p < 0.001), but less likely to have lymph nodes dissected (68% [664/974] vs. 76% [2210/2905], p < 0.001]. Among the 2944 patients with muscle-invasive urothelial carcinoma treated with cystectomy, use of neoadjuvant (5% vs. 4%, p = 0.419) and adjuvant chemotherapy (18% vs. 20%, p = 0.190) did not differ significantly between genders. Five-year cancer-specific survival and overall survival of the full cohort did not differ between women and men (38% vs. 39%, p = 0.522; 33% vs. 33%, p = 0.795).Conclusions: This population-based cohort did not demonstrate any substantial differences in extent of disease, treatment, or outcome between women and men treated with cystectomy or radical RT for bladder cancer.

scholarly journals Outcome of Combined Hepatocellular and Cholangiocarcinoma of the Liver

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Jue Wang ◽  
Fenwei Wang ◽  
Anne Kessinger
Keyword(s):  
Logistic Regression ◽  
Proportional Hazards ◽  
Liver Tumors ◽  
Tumor Stage ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cancer Specific Survival ◽  
Primary Liver Tumors ◽  
Combined Hepatocellular And Cholangiocarcinoma ◽  
Undifferentiated Histology

Background. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of combined hepatocellular and cholangiocarcinoma (cHCC-CC) using population-based registry.Methods. The Surveillance, Epidemiology, and End Results Program database (1973–2004) was used to identify cases of cHCC-CC. Multivariable logistic regression was used to evaluate factors associated with cancer-directed surgery (CDS). The influence of CDS on cancer specific survival was evaluated using Kaplan-Meier curves and Cox proportional hazards modeling.Results. A total of 380 cases of cHCC-CC were identified, which account for approximately 0.87% of primary liver tumors. Of all patients, 69.8% of patients had regional or distant stage; 65.6% of patients had poorly or undifferentiated histology. Only 44.9% of patients with localized disease, received CDS. By logistic regression analysis, being widowed, advanced stage, and earlier diagnosis year were associated with lower rate of utilization of CDS. In multivariate analysis, tumor stage, receipt of CDS, and recent year of diagnosis were found to be significant predictors for cancer-specific survival.Conclusions. Patients with localized cHCC-CC who are selected for CDS were strongly associated with improved survival. However, many patients with localized tumors did not receive potentially curative cancer-directed surgery. Further study is warranted to address the barriers to the delivery of appropriate care to these patients.

scholarly journals Downstaging of TURBT-Based Muscle-Invasive Bladder Cancer by Radical Cystectomy Predicts Better Survival

ISRN Urology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
P. R. van Dijk ◽  
M. Ploeg ◽  
K. K. H. Aben ◽  
P. C. Weijerman ◽  
H. F. M. Karthaus ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Relative Survival ◽  
Population Based ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Specific Survival ◽  
Tumor Downstaging ◽  
Muscle Invasive ◽  
The Impact

Differences between clinical (cT) and pathological tumor (pT) stage occur often after radical cystectomy (RC) for muscle-invasive bladder cancer. In order to evaluate the impact of downstaging on recurrence and survival, we selected patients from a large, contemporary, population-based series of 1,409 patients with MIBC. We included all patients who underwent RC (N=643) and excluded patients who received (neo)adjuvant therapy, those with known metastasis at time of diagnosis, and those with nonurothelial cell tumors. Disease outcomes were defined as recurrence-free survival (RFS) and relative survival (RS), as a good approximation of bladder cancer-specific survival. After applying the exclusion criteria, 375 patients were eligible for analysis. Tumor downstaging was found to be common after RC; in 99 patients (26.4%), tumor downstaging to non-muscle-invasive stages at RC occurred. Hydronephrosis at baseline and positive lymph nodes at RC occurred significantly less often in these patients. In 62 patients, no tumor was left in the cystectomy specimen. pT stage was pT1 in 20 patients and pTis in 17 patients. Patients with tumor downstaging have about a 30% higher RFS and RS compared to those without. Consequently, tumor downstaging is a favorable marker for prognosis after RC.

scholarly journals Prognostic impact of ReTURB in high grade T1 primary bladder cancer

2016 ◽  
Vol 88 (2) ◽  
pp. 81 ◽  
Author(s):  
Roberto Sanseverino ◽  
Giorgio Napodano ◽  
Antonio Campitelli ◽  
Maria Addesso
Keyword(s):  
Bladder Cancer ◽  
Progression Free Survival ◽  
Invasive Disease ◽  
Prognostic Impact ◽  
Residual Tumour ◽  
High Grade ◽  
Bcg Therapy ◽  
Primary Bladder ◽  
Muscle Invasive ◽  
Intravesical Bcg Therapy

Purpose: To evaluate whether pathological outcomes of ReTURB have a prognostic impact on recurrence and progression of primitive T1HG bladder cancer. Material and methods: Patients affected by primitive T1HG TCC of bladder underwent restaging TURB (ReTURB). Patients with muscle invasive disease at ReTURB underwent radical cystectomy; those with non-muscle invasive residual (NMI-RT) and those with no residual tumour (NRT) received an intravesical BCG therapy. We compared recurrence and progression in NMIRT patients and NRT patients at restaging TURB. Patients were followed every 3-6 months with cystoscopy and urine cytology. Results: 212 patients were enrolled in the study. At ReTURB, residual cancer was detected in 92 of 196 (46.9%) valuable patients: 14.3% of these were upstaged to T2. At follow up of 26.3 ± 22.8 months, there were differences in recurrence and progression rates between NRT and NMIRT patients: 26.9% and 45.3% (p &lt; 0.001), 10.6% and 23.4% (p 0.03), respectively. Recurrence-free and progression-free survivals were significantly higher in NRT compared to NMIRT patients: 73.1% and 54.7% (p &lt; 0.001), 89.4% and 76.6 (p 0.03), respectively. Conclusions: ReTURB allows to identify a considerable number of residual and understaged cancer. Patients with NMIRT on ReTURB have worse prognosis than those with NRT in terms of recurrence and progression free survival. These outcomes seem to suggest a prognostic impact of findings on ReTURB that could be a valid tool in management of high grade T1 TCC.

scholarly journals Surgical Compliance and Survival Outcomes For Patients With Osteosarcoma: A Population-Based Database Study

2021 ◽  
Author(s):  
Chao Tang ◽  
Dongdong Wang ◽  
Hailong Zhang
Keyword(s):  
Logistic Regression Model ◽  
Tumor Stage ◽  
Population Based ◽  
Cancer Specific Survival ◽  
Poor Grade ◽  
Factors Associated ◽  
The Poor ◽  
Kaplan Meier ◽  
Diagnostic Time ◽  
Economic Income

Abstract PurposeWe aimed to determine the effect of surgical compliance on prognosis in patients with osteosarcoma and the risk factors leading to surgical noncompliance.MethodsWe analyzed the date collected 3412 osteosarcoma patients from the Surveillance Epidemiology and End Results (SEER) databases between 1973 and 2015. Cox analyses were used to identify the independent prognostic factors. Logistic regression model was conducted to clear the factors associated to surgical compliance; Kaplan-Meier estimator method was adopted to analyze the Overall survival (OS) and Cancer-specific survival (CSS). ResultsAmong 3412 eligible osteosarcoma patients, the poor surgical compliance of patients with osteosarcoma is associated with the earlier time of diagnosis, advanced age, lower economic income, poor grade, distant stage, accepting radiotherapy and refusing chemotherapy. There were significant differences in the effects of diagnostic time, age, grade, radiotherapy, chemotherapy, tumor stage and economic income on surgical compliance (All P < 0.05). Patients’ compliance was an independent prognostic factor for OS and CSS of osteosarcoma patients. ConclusionsOsteosarcoma patients with good surgical compliance have favorable survival. This can help clinicians effectively realize patients' views on surgery and guide patients to learn the signification of surgery.

scholarly journals Adjuvant Intravesical Bacillus Calmette-Guérin Therapy and Survival Among Elderly Patients With Non–Muscle-Invasive Bladder Cancer

2013 ◽  
Vol 9 (2) ◽  
pp. 92-98 ◽  
Author(s):  
Benjamin A. Spencer ◽  
Russell B. McBride ◽  
Dawn L. Hershman ◽  
Donna Buono ◽  
Harry W. Herr ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Older Patients ◽  
Large Population ◽  
Population Based ◽  
Bacillus Calmette Guerin ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Specific Survival ◽  
Population Based Study ◽  
Intravesical Bcg ◽  
Muscle Invasive

This large population-based study found improved OS and bladder cancer–specific survival associated with use of adjuvant intravesical BCG among older patients with NMIBC.

Residual pathologic stage at radical cystectomy and risk stratification of patients with pT2N0 bladder cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5076-5076
Author(s):  
H. Isbarn ◽  
G. Sonpavde ◽  
S. F. Shariat ◽  
G. S. Palapattu ◽  
A. I. Sagalowsky ◽  
...  
Keyword(s):  
High Risk ◽  
Urinary Bladder ◽  
Adjuvant Therapy ◽  
Risk Stratification ◽  
Radical Cystectomy ◽  
Cox Regression ◽  
Transitional Cell ◽  
Invasive Disease ◽  
Cancer Specific Survival ◽  
Muscle Invasive

5076 Background: We hypothesized that in patients with pT2N0 transitional cell carcinoma (TCC) of the urinary bladder, residual muscle-invasive disease at radical cystectomy (RC) may confer poorer outcomes than residual non-muscle invasive disease due to larger tumor volume and/or biologically more aggressive disease. Patients with high-risk pT2N0 disease may be candidates for trials of adjuvant therapy. Methods: Patients from the BCRC database with pT2N0 stage (N = 208) at TUR (transurethral resection) whose tumors were organ-confined at RC (≤pT2N0) were analyzed. T1N0 patients (N=33) with pT2 disease at RC were also examined in order to include all pT2 patients. None of the patients had received perioperative chemotherapy. The effect of residual pT-stage at RC on outcomes was evaluated in Kaplan-Meier, as well as in univariable and multivariable Cox-regression models. Covariates consisted of age, gender, grade, lymphovascular invasion, concomitant carcinoma-in-situ (CIS), number of lymph nodes removed, and the year of surgery. Results: Among baseline T2N0 patients, residual pT-stage at RC was pT0 in 24 (11.5%), pTa in 9 (4.3%), pCIS in 22 (10.6%), pT1 in 35 (16.8%), and pT2 in 118 patients (56.7%). The median follow-up was 50.1 months. The 5-year recurrence-free survivals of patients with residual pT0/pTa/pCis, pT1 and pT2 were 100%, 85% and 75%, respectively. The 5-year cancer-specific survival rates for the same patient cohorts were 100%, 93%, and 81%, respectively. In multivariable analyses, the effect of residual stage <pT2 at RC achieved independent predictor status for recurrence (adjusted HR 0.20; p = 0.002), as well as for cancer-specific survival (adjusted HR: 0.24; p = 0.02). Initial T1 patients who were pT2 at RC did not have statistically different outcomes compared to initial T2 followed by pT2 at RC. Conclusions: Patients with pT2N0 TCC of the urinary bladder with residual non-muscle invasive disease at RC have significantly better long-term outcomes compared to residual muscle-invasive disease. With further validation, these data may facilitate the risk-stratification of patients with pT2N0 disease and enable the selection of high-risk patients for trials of adjuvant therapy. No significant financial relationships to disclose.

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