Prognostic Variables in Patients With Non-metastatic Small-cell Neuroendocrine Carcinoma of the Bladder: A Population-Based Study.
Adult
Aged
Aged, 80 and over
Carcinoma, Neuroendocrine
/ pathology
Carcinoma, Small Cell
/ pathology
Chemotherapy, Adjuvant
Combined Modality Therapy
/ methods
Female
Humans
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Prognosis
Radiotherapy, Adjuvant
Retrospective Studies
SEER Program
Survival Analysis
Treatment Outcome
Urinary Bladder Neoplasms
/ pathology
Urologic Surgical Procedures
Neuroendocrine bladder cancer
Prognostic variables
SCCB
SEER
Small-cell bladder cancer
Journal
Clinical genitourinary cancer
ISSN: 1938-0682
Titre abrégé: Clin Genitourin Cancer
Pays: United States
ID NLM: 101260955
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
05
09
2018
revised:
05
02
2019
accepted:
17
03
2019
pubmed:
5
6
2019
medline:
17
4
2020
entrez:
5
6
2019
Statut:
ppublish
Résumé
Small-cell carcinoma of the bladder (SCCB) is a rare, highly aggressive, neoplasm. We retrospectively analyzed the Surveillance, Epidemiology, and End Results (SEER) database to investigate the impact of chemotherapy, surgery, and radiotherapy on overall survival (OS) of patients with non-metastatic SCCB. The SEER Research Data (2000-2014) were reviewed using the SEER*Stat software. Patients with pure or mixed SCCB, T2-T4, any N, M0, and who received either surgery or radiotherapy with or without chemotherapy (neo-adjuvant, adjuvant, or perioperative treatment) were included. We used the Kaplan-Meier method and log-rank test for estimating survival. Cox proportional hazard regression was used to evaluate the prognostic variables. A total of 384 cases of SCCB were included in the study (T2, n = 204; T3/4, n = 180), of whom 233 (60.7%) were treated with surgery, whereas 151 (39.3%) received radiotherapy. The median OS was 21.0 months (95% confidence interval [CI], 16.7-25.3 months). Age, race, chemotherapy, type of local treatment, and T and N staging were identified as independent prognostic variables (P < .05). In multivariate analysis, chemotherapy (n = 264) was associated with significant better OS (adjusted hazard ratio [HR], 0.56; 95% CI, 0.42-0.74; P < .000). Patients who underwent surgery showed longer outcome compared with those treated with radiotherapy (adjusted HR, 0.62; 95% CI, 0.47-0.82; P = .001). However, only in the T2 subgroup did surgery (n = 92) retain a significant survival difference compared with radiotherapy (n = 112) (adjusted HR, 0.37; 95% CI, 0.24-0.57; P < .000). Surgery was associated with better outcome compared with radiotherapy in patients with T2 disease. Chemotherapy was associated with a longer survival in patients with non-metastatic SCCB.
Sections du résumé
BACKGROUND
Small-cell carcinoma of the bladder (SCCB) is a rare, highly aggressive, neoplasm. We retrospectively analyzed the Surveillance, Epidemiology, and End Results (SEER) database to investigate the impact of chemotherapy, surgery, and radiotherapy on overall survival (OS) of patients with non-metastatic SCCB.
MATERIALS AND METHODS
The SEER Research Data (2000-2014) were reviewed using the SEER*Stat software. Patients with pure or mixed SCCB, T2-T4, any N, M0, and who received either surgery or radiotherapy with or without chemotherapy (neo-adjuvant, adjuvant, or perioperative treatment) were included. We used the Kaplan-Meier method and log-rank test for estimating survival. Cox proportional hazard regression was used to evaluate the prognostic variables.
RESULTS
A total of 384 cases of SCCB were included in the study (T2, n = 204; T3/4, n = 180), of whom 233 (60.7%) were treated with surgery, whereas 151 (39.3%) received radiotherapy. The median OS was 21.0 months (95% confidence interval [CI], 16.7-25.3 months). Age, race, chemotherapy, type of local treatment, and T and N staging were identified as independent prognostic variables (P < .05). In multivariate analysis, chemotherapy (n = 264) was associated with significant better OS (adjusted hazard ratio [HR], 0.56; 95% CI, 0.42-0.74; P < .000). Patients who underwent surgery showed longer outcome compared with those treated with radiotherapy (adjusted HR, 0.62; 95% CI, 0.47-0.82; P = .001). However, only in the T2 subgroup did surgery (n = 92) retain a significant survival difference compared with radiotherapy (n = 112) (adjusted HR, 0.37; 95% CI, 0.24-0.57; P < .000).
CONCLUSIONS
Surgery was associated with better outcome compared with radiotherapy in patients with T2 disease. Chemotherapy was associated with a longer survival in patients with non-metastatic SCCB.
Identifiants
pubmed: 31160193
pii: S1558-7673(18)30659-1
doi: 10.1016/j.clgc.2019.03.010
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e724-e732Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.