Prognostic significance of non-urothelial carcinoma of bladder: analysis of nationwide hospital-based cancer registry data in Japan
Prognostic significance of non-urothelial carcinoma of bladder: analysis of nationwide hospital-based cancer registry data in Japan
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DOI：
10.1093/jjco/hyaa072
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发表时间：
2020-09-01
影响因子：
2.4
通讯作者：
Nishiyama, Hiroyuki
中科院分区：
文献类型：
--
作者：
Nagumo, Yoshiyuki;Kawai, Koji;Nishiyama, Hiroyuki
目的：探讨膀胱纯非尿路上皮癌（non-UC）的预后，并与纯尿路上皮癌（UC）的预后进行比较。方法：我们使用日本全国医院癌症登记数据，提取2008-2009年经组织学证实的纯非UC和UC膀胱病例。我们通过Kaplan-Meier分析估计5年总生存期（OS）。结果：共鉴定出8094例膀胱癌组织学亚型确诊患者。最常见的纯非uc是鳞状细胞癌（SQ, n = 192, 2.4%），其次是腺癌（AC, n = 138, 1.7%）和小细胞神经内分泌癌（SmC, n = 54, 0.7%）。SQ组女性患者比例（48%）明显高于单纯UC组（P < 0.001）。非UC患者的5年OS率明显低于UC患者（40% vs. 61%, P < 0.001）。根据分期，I期和ii期非UC患者的5年OS率明显低于UC患者（P = 0.001）。考虑组织学亚型和分期，一期SQ患者的5年OS率低于AC和SmC患者（分别为46%、68%和64%）。结论：单纯非UC患者预后较单纯UC患者差，尤其是I期和ii期非UC患者。为了改善这些患者的肿瘤预后，对于非uc的I期患者，特别是纯SQ患者，可能需要更积极的手术方法。
Objectives: To identify the prognosis of pure non-urothelial carcinoma (non-UC) of bladder and to compare them with those of pure urothelial carcinoma (UC).Methods: We used Japan's nationwide hospital-based cancer registry data to extract histologically confirmed pure non-UC and UC cases of bladder diagnosed in 2008-2009. We estimated the 5-year overall survival (OS) by a Kaplan-Meier analysis.Results: A total of 8094 patients with confirmed histological subtypes of bladder cancer were identified. The most common pure non-UC was squamous cell carcinoma (SQ, n = 192, 2.4%) followed by adenocarcinoma (AC, n = 138, 1.7%) and small cell neuroendocrine carcinoma (SmC, n = 54, 0.7%). The proportion of female patients (48%) was significantly higher in the SQ group compared with the pure UC group (P < 0.001). The 5-year OS rate of the non-UC patients was significantly worse than that of the UC patients (40 vs. 61%, P < 0.001). According to stages, the 5-year OS rates of the stage I and Ill non-UC patients were significantly worse than those of the UC patients (P = 0.001). Considering histologic subtypes and stages, the 5-year OS rates of the stage I SQ patients were worse than those of the AC and SmC patients (46, 68 and 64%, respectively).Conclusion: The prognosis of pure non-UC was worse than that of pure UC, especially in the stage I and Ill non-UC patients. To improve these patients' oncologic outcomes, a more aggressive surgical approach may be necessary in stage I patients with non-UC, especially in pure SQ.