Reviewing the Demographic, Prognostic, and Treatment Factors of Primary Adenocarcinoma of the Bladder: A SEER Population-based Study.

INTRODUCTION

The objective of this study was to characterize the demographic, prognostic, and treatment factors for patients with primary adenocarcinoma of the bladder by analyzing the impact of histologic subtype in a large sample size and interpreting newly released Surveillance, Epidemiology, and End Results (SEER) chemotherapy data.

MATERIALS AND METHODS

The SEER 18 Registry was utilized to identify cases of primary adenocarcinoma diagnosed from 1973 to 2015. Demographic data, tumor and disease characteristics, treatment information, and survival outcome data were collected. Overall survival and disease-specific survival were determined using Kaplan-Meier curve analysis. Univariate and multivariate Cox regression analysis were then completed using SAS JMP.

RESULTS

A total of 2305 cases of primary adenocarcinoma of the bladder were identified. Overall survival at 2-, 5- and 10-year intervals was 54.8%, 36.1%, and 25.4%, respectively. Disease-specific survival at 2-, 5- and 10-year intervals was 62.0%, 47.1%, and 40.1%, respectively. Patients were treated with surgery (86.4%), chemotherapy (21.9%), and radiation (15.0%) (P < .0001). Multivariate Cox regression analysis showed independent prognostic value for gender, stage, grade, primary tumor location, and histologic subtype. The urachus/dome location conferred survival advantage over non-urachal locations on univariable and multivariable Cox regression analysis. The papillary adenocarcinoma subtype conferred the best survival outcome, whereas signet cell carcinoma (hazard ratio, 2.069; P < .0001) and unclassified adenocarcinoma (not otherwise specified) (hazard ratio, 1.524; P < .0001) conferred the worst prognoses.

CONCLUSION

This study utilized a population-based analysis to showcase the utility of various prognostic features in primary bladder adenocarcinoma cases. In characterizing treatments, we find the prevailing treatment remains surgical intervention, whereas a sizable minority receives chemotherapy and/or radiation, often in combination with surgery.