Liu Liang, Yuan Haibo, Wang Qiang, Li Chuangui
Department of Urology, Baoding No. 1 Central Hospital, Baoding 071000, China.
J Oncol. 2022 Nov 2;2022:8594022. doi: 10.1155/2022/8594022. eCollection 2022.
To assess the prognosis of stage IV metastatic urinary bladder urothelial carcinoma (UBUC) at initial diagnosis and determine prognostic factors based on distant organ metastasis.
A retrospective cohort analysis of UBUC was conducted based on the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression analyses were used to determine the variables associated with overall survival (OS). Kaplan-Meier curves were used to compare survival curves among different groups.
A total of 3103 patients with stage IV UBUC were selected for analysis. The number of distant organ metastatic sites independently predicted the OS. The OS was not different in other metastatic sites when bone metastasis was used as a reference ( > 0.05). However, the OS was shorter for a single metastatic site ( < 0.001) and multiple metastatic sites when metastasis was not used as a reference ( < 0.001). Multivariable Cox regression analysis indicated that low survivorship was independently associated with no surgery for the entire cohort and patients with only one metastatic organ. Sex ( = 0.019) and grade ( = 0.046) were the independent risk factors for patients with only one metastatic organ.
These results show that the prognosis of stage IV metastatic UBUC is not different between any single metastatic organ. The prognosis of stage IV metastatic UBUC depends on the number of distant organ metastasis. This study determined some predictors of survival and thus may help therapists to choose appropriate treatment strategies for metastatic UBUC.
评估初诊时IV期转移性膀胱尿路上皮癌（UBUC）的预后，并根据远处器官转移情况确定预后因素。
基于监测、流行病学和最终结果（SEER）数据库对UBUC进行回顾性队列分析。采用单因素和多因素Cox回归分析确定与总生存期（OS）相关的变量。使用Kaplan-Meier曲线比较不同组之间的生存曲线。
共纳入3103例IV期UBUC患者进行分析。远处器官转移部位的数量独立预测OS。以骨转移为参照时，其他转移部位的OS无差异（>0.05）。然而，当不以转移为参照时，单个转移部位（<0.001）和多个转移部位的OS较短（<0.001）。多因素Cox回归分析表明，对于整个队列以及仅患有一个转移器官的患者，低生存率与未接受手术独立相关。性别（=0.019）和分级（=0.046）是仅患有一个转移器官患者的独立危险因素。
这些结果表明，IV期转移性UBUC在任何单个转移器官之间的预后无差异。IV期转移性UBUC的预后取决于远处器官转移的数量。本研究确定了一些生存预测因素，因此可能有助于治疗师为转移性UBUC选择合适的治疗策略。
