Hemade Ali, Hallit Souheil
Faculty of Medicine, Lebanese University, Hadat, Lebanon.
School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
Ann Med Surg (Lond). 2024 Sep 18;86(10):5716-5723. doi: 10.1097/MS9.0000000000002581. eCollection 2024 Oct.
Bladder cancer is a heterogeneous disease with varying prognostic outcomes based on the primary tumor site within the bladder. This study aims to evaluate the impact of tumor location on overall survival and cancer-specific survival in bladder cancer patients.
The authors conducted a retrospective cohort study using data from the Surveillance, Epidemiology, and End Results database. Patients with primary transitional cell carcinoma of the bladder were categorized based on their tumor locations. Survival outcomes were assessed using Kaplan-Meier analysis and Cox proportional hazards regression models, adjusted for age, sex, race, cancer stage, and treatment modalities. Additionally, binary logistic regression models were employed to predict overall mortality (OM) and cancer-specific mortality (CSM) at 1, 5, and 10 years.
The study included 107 909 patients diagnosed with primary bladder cancer between 2000 and 2021. Significant differences in survival outcomes were observed across different tumor sites. Bladder cancer originating in the urachus had the worst OS before 100 months and the worst CSS overall. Tumors in the anterior wall showed the worst OS after 100 months. In the Cox multivariable analysis, anterior wall tumors were associated with a 1.513-fold increased risk of death compared to lateral wall tumors. The binary logistic regression models showed that anterior wall tumors predicted the highest OM and CSM at 1-year, while urachal tumors had the worst outcomes at 5 and 10 years.
The primary site of bladder cancer is a significant predictor of survival outcomes, with tumors in the urachus and anterior wall associated with a poorer prognosis. These findings underscore the importance of considering tumor location in the prognosis and management of bladder cancer. Future studies should aim to validate these findings in more diverse populations and explore the underlying biological mechanisms that drive these differences.
膀胱癌是一种异质性疾病，其预后结果因膀胱内原发肿瘤部位而异。本研究旨在评估肿瘤位置对膀胱癌患者总生存期和癌症特异性生存期的影响。
作者使用监测、流行病学和最终结果数据库的数据进行了一项回顾性队列研究。膀胱原发性移行细胞癌患者根据其肿瘤位置进行分类。使用Kaplan-Meier分析和Cox比例风险回归模型评估生存结果，并对年龄、性别、种族、癌症分期和治疗方式进行了调整。此外，采用二元逻辑回归模型预测1年、5年和10年时的总死亡率（OM）和癌症特异性死亡率（CSM）。
该研究纳入了2000年至2021年间诊断为原发性膀胱癌的107909例患者。在不同肿瘤部位观察到生存结果存在显著差异。起源于脐尿管的膀胱癌在100个月前总生存期最差，总体癌症特异性生存期也最差。前壁肿瘤在100个月后总生存期最差。在Cox多变量分析中，与侧壁肿瘤相比，前壁肿瘤的死亡风险增加了1.513倍。二元逻辑回归模型显示，前壁肿瘤在1年时预测的总死亡率和癌症特异性死亡率最高，而脐尿管肿瘤在5年和10年时预后最差。
膀胱癌的原发部位是生存结果的重要预测因素，脐尿管和前壁的肿瘤预后较差。这些发现强调了在膀胱癌的预后和管理中考虑肿瘤位置的重要性。未来的研究应旨在在更多样化的人群中验证这些发现，并探索导致这些差异的潜在生物学机制。
