Secondary bladder cancer after upper tract urothelial carcinoma in the US population
Secondary bladder cancer after upper tract urothelial carcinoma in the US population
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DOI：
10.1111/j.1464-410x.2012.11108.x
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发表时间：
2012-11-01
影响因子：
4.5
通讯作者：
McKiernan, James M.
中科院分区：
文献类型：
--
作者：
Kates, Max;Badalato, Gina M.;McKiernan, James M.
目的探讨上尿路上皮癌（UTUC）的自然病史及下尿路继发癌的发展情况。患者和方法1975年至2005年间诊断为UTUC的患者在9个监测、流行病学和最终结果登记处中被确定。比较继发性膀胱癌患者和非继发性膀胱癌患者的基线特征。采用多变量logistic回归模型检验诊断年份是否能预测继发性膀胱癌的发生可能性。结果5212例UTUC患者中，242例（4.6%）有继发性膀胱癌（范围：1.7-8.2%）。两次癌症诊断之间的平均间隔为26.5个月（95% CI: 22.2-30.8）。与无继发性肿瘤的患者相比，继发性膀胱恶性肿瘤患者更有可能出现较大的肿瘤（4.2 vs 3.1 cm, P < 0.001）和肿瘤位于输尿管（P < 0.001）。在控制人口统计学和肿瘤特征的多变量分析中，诊断年份不是继发性膀胱恶性肿瘤可能性的预测因子（优势比：0.99;95% CI: 0.95-1.03）。结论：输尿管较大的尿路上皮肿瘤患者最有可能发展为继发性下尿路肿瘤。在30年的研究期间，UTUC患者的继发性膀胱癌发生率没有纵向变化。
OBJECTIVETo assess the natural history of upper tract urothelial carcinoma (UTUC) and the development of lower tract secondary cancer.PATIENTS AND METHODSPatients diagnosed with UTUC between 1975 and 2005 were identified within nine Surveillance, Epidemiology and End Results registries.Baseline characteristics of patients with and without secondary bladder cancer were compared.A multivariate logistic regression model was fitted to test if the year of diagnosis predicted the likelihood of developing a secondary bladder cancer.RESULTSOf the 5212 patients with UTUC, 242 (4.6%) had a secondary bladder cancer (range: 1.7-8.2%).There was a mean interval of 26.5 (95% CI: 22.2-30.8) months between cancer diagnoses.Compared with those without secondary tumours, patients with secondary bladder malignancy were more likely to present with larger tumours (4.2 vs 3.1 cm, P < 0.001) and with tumours located in the ureter (P < 0.001).Year of diagnosis was not a predictor of the likelihood of having a secondary bladder malignancy in a multivariate analysis controlling for demographic and tumour characteristics (odds ratio: 0.99; 95% CI: 0.95-1.03)CONCLUSIONSPatients with larger urothelial tumours located in the ureter were those most likely to develop a secondary lower tract tumour.No longitudinal changes in the rate of secondary bladder cancer were noted among patients with UTUC over the 30-year study period.