Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy; Department of Urology, Vita-Salute San Raffaele University, Milan, Italy.
Clin Genitourin Cancer. 2024 Oct;22(5):102139. doi: 10.1016/j.clgc.2024.102139. Epub 2024 Jun 13.
To test the association between number as well as locations of organ-specific metastatic sites and overall survival (OS) in systhemic-therapy exposed metastatic urothelial carcinoma of urinary bladder (mUCUB) patients.
Within Surveillance, Epidemiology and End Results database (2010-2020), all systhemic therapy-exposed mUCUB patients were identified. Kaplan-Meier and multivariable Cox regression (CRM) models first addressed OS in patients according to number of metastatic organ-locations: solitary versus 2 versus 3 or more. Subsequently, separate analyses stratified according to location type were completed in patients with solitary metastatic organ-location as well as in patients with 2 metastatic organ-locations.
Of 1,310 mUCUB, 1,069 (82%) harbored solitary metastatic organ-location versus 193 (15%) harbored 2 separate metastatic organ-locations versus 48 (3%) harbored 3 or more metastatic organ-locations. Median OS decreased with increasing number of metastatic organ-locations (solitary vs. 2 vs. 3 or more, P < .0001). In multivariable CRM, relative to solitary metastatic organ-location, 2 (HR: 1.57, 95 Confidence interval [CI], 1.33-1.85) as well as 3 or more (HR: 1.69, 95% CI, 1.23-2.31) metastatic organ-locations independently predicted higher overall mortality (OM) (P = .001). In patients with solitary metastatic organ-location, brain metastases independently predicted higher OM (HR 1.67; 95% CI, 1.05-2.67; P = .03) than other locations. In patients with 2 metastatic organ-locations, no differences in OM were recorded according to organ type location.
In systemic therapy exposed mUCUB, number of metastatic organ-locations (solitary vs. 2 vs. 3 or more), independently predicted increasingly worse prognosis. In patients with solitary metastatic organ-location, brain purported worse prognosis than others.
检测特定器官转移部位数量和位置与接受系统治疗的转移性膀胱癌（mUCUB）患者总生存期（OS）之间的关系。
本研究利用 Surveillance, Epidemiology and End Results 数据库（2010-2020 年），筛选所有接受系统治疗的 mUCUB 患者。Kaplan-Meier 生存分析和多变量 Cox 回归模型（CRM）首先根据转移器官部位数量评估患者的 OS：单发、2 个部位或 3 个及以上部位。随后，对单发转移器官部位的患者和 2 个转移器官部位的患者分别进行分层分析。
在 1310 例 mUCUB 患者中，1069 例（82%）为单发转移器官部位，193 例（15%）为 2 个不同转移器官部位，48 例（3%）为 3 个或更多转移器官部位。随着转移器官部位数量的增加，中位 OS 逐渐降低（单发 vs. 2 个部位 vs. 3 个及以上部位，P <.0001）。在多变量 CRM 中，与单发转移器官部位相比，2 个（HR：1.57，95%CI，1.33-1.85）和 3 个或更多（HR：1.69，95%CI，1.23-2.31）转移器官部位独立预测更高的总死亡率（OM）（P =.001）。在单发转移器官部位的患者中，脑转移独立预测更高的 OM（HR 1.67；95%CI，1.05-2.67；P =.03），而其他部位则没有。在 2 个转移器官部位的患者中，根据器官类型部位，OM 没有差异。
在接受系统治疗的 mUCUB 患者中，转移器官部位的数量（单发 vs. 2 个部位 vs. 3 个或更多部位）独立预测预后越来越差。在单发转移器官部位的患者中，脑转移提示预后更差。
