Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
J Urol. 2010 Mar;183(3):915-20. doi: 10.1016/j.juro.2009.11.018. Epub 2010 Jan 18.
Nonurothelial malignancies represent a small fraction of bladder malignancies and are less extensively studied, resulting in sparse empirical data on these tumors. We sought insight into tumor characteristics and survival.
Data were obtained from the nationwide Netherlands Cancer Registry on patient and tumor characteristics, and followup in all patients with primary invasive (T1 or greater) bladder tumors in The Netherlands between 1995 and 2006. Data were analyzed using frequency tables. Relative survival analysis was done.
We identified 28,807 patients with invasive bladder cancer, of whom 7.7% presented with nonurothelial carcinoma. Mean patient age range at diagnosis of adenocarcinoma and soft tissue tumors was 66.4 years, and 78.3 years at diagnosis of nonspecified tumors. Most histological subtypes were more common in males except squamous cell carcinoma and lymphoma. Muscle invasion was seen in 52.2% of urothelial carcinoma cases vs 87.5%, 71.9% and 89.0% of squamous cell carcinoma, adenocarcinoma and neuroendocrine tumor cases, respectively. For urothelial carcinoma, squamous cell carcinoma and adenocarcinoma women presented at more advanced stage. In the neuroendocrine group this stage difference was the opposite. Survival analysis showed a 5-year relative survival rate of 32.2%, 22.9%, 31.8% and 21.1% for T2 or greater urothelial carcinoma, squamous cell carcinoma, adenocarcinoma and neuroendocrine tumors, respectively.
Patients with nonurothelial carcinoma present at more advanced stage and overall have worse survival. Relative survival of muscle invasive adenocarcinoma equals survival of muscle invasive urothelial carcinoma. For stage II and III disease these cases do even better. Muscle invasive squamous cell carcinoma and neuroendocrine tumors show worse survival regardless of stage.
非尿路上皮恶性肿瘤占膀胱恶性肿瘤的一小部分，研究较少，因此这些肿瘤的经验数据很少。我们试图深入了解肿瘤特征和生存情况。
数据来自于 1995 年至 2006 年期间荷兰全国癌症登记处的患者和肿瘤特征以及所有荷兰原发性浸润性（T1 或更高）膀胱癌患者的随访数据。使用频率表进行数据分析。进行相对生存分析。
我们确定了 28807 例浸润性膀胱癌患者，其中 7.7%为非尿路上皮癌。腺癌和软组织肿瘤的平均患者年龄范围为 66.4 岁，未指定肿瘤的平均年龄为 78.3 岁。除鳞状细胞癌和淋巴瘤外，大多数组织学亚型在男性中更为常见。在尿路上皮癌病例中，肌肉浸润见于 52.2%，而在鳞状细胞癌、腺癌和神经内分泌肿瘤病例中，分别为 87.5%、71.9%和 89.0%。对于尿路上皮癌、鳞状细胞癌和腺癌，女性的分期更为晚期。在神经内分泌组中，这种分期差异则相反。生存分析显示，T2 或更高的尿路上皮癌、鳞状细胞癌、腺癌和神经内分泌肿瘤的 5 年相对生存率分别为 32.2%、22.9%、31.8%和 21.1%。
非尿路上皮癌患者的分期更为晚期，总体生存率较差。浸润性腺癌的相对生存率与浸润性尿路上皮癌的生存率相等。对于 II 期和 III 期疾病，这些病例的生存情况更好。无论分期如何，浸润性鳞状细胞癌和神经内分泌肿瘤的生存率均较差。
