Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China.
BMC Cancer. 2020 Nov 25;20(1):1148. doi: 10.1186/s12885-020-07655-x.
Population-based analysis for the short-term non-bladder cancer related mortality among patients with non-metastatic bladder cancer is currently lacking. The objective of the current study was to assess and quantify cause of death after bladder cancer diagnosis.
The custom Surveillance, Epidemiology, and End Results (SEER) dataset for standardized mortality ratios (SMRs) was utilized to identify 24,074 patients who were diagnosed with nonmetastatic (M0) bladder cancer from 2014 to 2015. SMRs for causes of death were calculated. Risk factors for bladder cancer-specific mortality, competing mortality, second-cancer mortality, and noncancer mortality were determined using either multivariable Cox or competing risk regression models.
Among all the 4179 (17.4%) deaths occurred during the follow-up period, almost half of them (44.2%) were attributed to non-bladder cancer cause, including second non-bladder cancer (10%) and other non-cancer causes (34.2%). The most common noncancer causes of death were heart diseases followed by chronic obstructive pulmonary disease. Patients had a higher risk of death from second malignancies (SMR, 1.59; 95% CI, 1.47-1.74) compared with death from first malignancies in the US general population, and also had higher risks of death from heart diseases (SMR, 1.29; 95% CI, 1.18-1.40) and chronic obstructive pulmonary disease (SMR, 1.52; 95% CI, 1.29-1.79) compared with the US general population. Additionally, some risk factors for competing second malignancies or noncancer mortality were determined, such as age, gender, marital status and treatment modalities.
Death from non-bladder cancer cause contributed to almost half of all deaths in bladder cancer survivors during the short-term follow-up period. These findings can inform medical management and assist clinicians in counseling those survivors regarding their short-term health risks.
目前缺乏基于人群的非转移性膀胱癌患者短期非膀胱癌相关死亡率的分析。本研究的目的是评估和量化膀胱癌诊断后的死亡原因。
利用定制的监测、流行病学和最终结果（SEER）数据集标准化死亡率比（SMR），确定 2014 年至 2015 年间诊断为非转移性（M0）膀胱癌的 24074 例患者。计算了死亡原因的 SMR。使用多变量 Cox 或竞争风险回归模型确定膀胱癌特异性死亡率、竞争死亡率、第二癌死亡率和非癌死亡率的危险因素。
在随访期间发生的所有 4179 例（17.4%）死亡中，近一半（44.2%）归因于非膀胱癌原因，包括第二非膀胱癌（10%）和其他非癌症原因（34.2%）。最常见的非癌症死亡原因是心脏病，其次是慢性阻塞性肺疾病。与美国普通人群中第一恶性肿瘤的死亡率相比，患者死于第二恶性肿瘤的风险更高（SMR，1.59；95%CI，1.47-1.74），死于心脏病（SMR，1.29；95%CI，1.18-1.40）和慢性阻塞性肺疾病（SMR，1.52；95%CI，1.29-1.79）的风险也更高。此外，还确定了一些竞争第二恶性肿瘤或非癌症死亡率的危险因素，如年龄、性别、婚姻状况和治疗方式。
在短期随访期间，非膀胱癌原因导致的死亡占膀胱癌幸存者所有死亡的近一半。这些发现可以为医疗管理提供信息，并帮助临床医生为这些幸存者提供短期健康风险咨询。
