Clinicopathological characteristics and survival outcomes of bladder neuroendocrine carcinomas: a population-based study
Authors Niu Q, Lu Y, Xu S, Shi Q, Guo B, Guo Z, Huang T, Wu Y, Yu J
Received 25 May 2018
Accepted for publication 27 July 2018
Published 11 October 2018 Volume 2018:10 Pages 4479—4489
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Dr Kenan Onel
Quan Niu,1,* Youyi Lu,2,* Shigao Xu,3 Qun Shi,3 Baoyu Guo,1 Zhe Guo,1 Tianbao Huang,3 Yinxia Wu,4 Junjie Yu3
1Department of Dalian Medical University, Dalian, Liaoning, People’s Republic of China; 2Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, People’s Republic of China; 3Department of Urology, Subei People’s Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People’s Republic of China; 4Department of Oncology, Subei People’s Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Background: Bladder neuroendocrine carcinomas (BNECs) are relatively a rare type of tumor. The aim of this study was to examine the clinicopathological characteristics and predictors of survival outcomes of patients with BNECs based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database.
Materials and methods: Kaplan–Meier analysis with log-rank test was used for survival comparisons. Multivariate Cox regression model was employed to analyze the effect of different treatments on overall survival (OS) and cancer-specific survival (CSS).
Results: A total of 910 patients were identified between 2004 and 2014. Overall, 648 (71.2%) patients had small cell neuroendocrine carcinoma (SCNEC), 35 (3.8%) had large cell neuroendocrine carcinoma (LCNEC), 10 (1.1%) had carcinoid tumor (well-differentiated neuroendocrine tumor), 16 (1.8%) had paraganglioma/pheochromocytoma (PGL/PHEO), 619 (68.0%) had a poorly differentiated or undifferentiated histology grade, 214 (23.5%) presented with metastatic disease, 586 (64.4%) underwent transurethral ablation/destruction for bladder tumor, and 245 (26.9%) had partial/total cystectomy. Cystectomy+chemotherapy+radiotherapy (CCR) has the highest long-term survival rate among various treatments. The 1-, 3-, and 5-years CSS of CCR were 56%, 56%, and 56%, respectively. By using multivariable Cox proportional hazard model, age, histology, N stage, SEER stage, tumor size, radiotherapy, chemotherapy, and local treatment of the primary site were identified as independent predictors for OS and CSS; all P<0.05.
Conclusion: In BNEC, SCNEC has an absolute advantage in number. SCNEC/LCNEC tend to be older men. PGL/PHEO and carcinoid tumors have younger mean ages, earlier tumor stages, and better prognosis than SCNEC/LCNEC. Surgery, radiotherapy and chemotherapy are better than conservative treatment. However, whatever cystectomy or bladder sparing, chemotherapy should be a major component of treatment.
Keywords: bladder neuroendocrine carcinomas, clinicopathological characteristics, prognosis, treatment, Surveillance, Epidemiology, and End Results
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