Clinical Features of Sarcomatoid Carcinoma (Carcinosarcoma) of the Urinary Bladder: Analysis of 221 Cases

Background. Urinary bladder sarcomatoid carcinoma (carcinosarcoma) is rare. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of urinary bladder carcinosarcoma using population-based registry.Methods. The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined.Results. A total of 221 histology confirmed cases were identified between 1973 and 2004, this accounted for approximately 0.11% of all primary bladder tumors during the study period. Median age of the patients was 75 years (range 41–96). Of the patients with a known tumor stage , 72.5% had a regional or distant stage; 98.4% of patients with known histology grade , had poorly or undifferentiated histology. Multiple primary tumors were indentified in about 40% of study subjects. The majority of patients (95.9%) received cancer directed surgery, 35.8% had radical or partial cystectomy, 15.8% of patients received radiation therapy combination with surgery. The median overall survival was 14 months (95% CI 7–21 months). 1-, 5-, and 10-year cancer specific survival rate were 53.9%, 28.4% and 25.8%. In a multivariate analysis, only tumor stage was found to be a significant prognostic factor for disease-specific survival.Conclusions. Urinary bladder carcinosarcoma commonly presented as high grade, advanced stage and aggressive behavior with a poor prognosis. Emphasis on early detection, including identification of risk factors is needed to improve the outcome for patients with this malignancy.

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The natural history, treatment pattern, and survival of the patients with micropapillary bladder.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e15015 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e15015-e15015

Author(s):

Jue Wang

Keyword(s):

Natural History ◽

Tumor Stage ◽

Invasive Disease ◽

Population Based ◽

Bladder Tumors ◽

Cancer Specific Survival ◽

Undifferentiated Histology ◽

Primary Bladder ◽

Muscle Invasive ◽

Population Based Registry

e15015 Background: Micropapillary bladder carcinoma (MPBC) is a rare variant of urothelial carcinoma. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of MPBC using population-based registry. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases of MPBC by tumor site and histology codes. The clinical, demographic characteristics, treatment and survival of MPBC were examined. Results: A total of 98 cases of histology confirmed MPBC were identified between 2001 and 2007, this accounted for approximately 0.01% of all primary bladder tumors during the study period. Median age of the patients was 72 years (range 26-95). Of all the patients with MPBC, 56.1% had muscle invasive disease; 75.5% of patients had poorly or undifferentiated histology. A total of 30.6% of all patients (2.3% superficial disease; 52.7% of muscle-invasive MPBC) had radical or partial cystectomy. By logistic regression analysis, nonmuscle-invasive MPBC (OR 62.5, 95% CI 7.2-542.3) was associated with lower rate of utilization of cystectomy. The 1-, 3- and 5-year overall survival rate of MPBC were 84.5%, 57.3% and 42.3%. In multivariate analysis, tumor stage (HR 4.7, 95% CI 1.0-21.8) was found to be the only significant predictor for cancer-specific survival. Conclusions: The optimal therapy for MPBC remains undermined. Emphasis on early detection is needed to improve the outcome for patients with this malignancy.

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The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis

Advances in Urology ◽

10.1155/2011/693964 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Jue Wang ◽

Fen Wei Wang ◽

Anne Kessinger

Keyword(s):

Natural History ◽

Renal Pelvis ◽

Histological Grade ◽

Tumor Stage ◽

Population Based ◽

Age At Diagnosis ◽

Cancer Specific Survival ◽

Entire Cohort ◽

Undifferentiated Histology ◽

Almost All

Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP) using population-based registry.Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER) database and reviewed.Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4–9). The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK) or renal pelvis (CSP). In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival.Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location.

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Multiple primary tumors in patients with carcinosarcoma of bladder: A coincidence or an etiological association? A study of 221 carcinosarcoma of bladder cases

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16138 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16138-e16138

Author(s):

J. Wang ◽

F. Wang

Keyword(s):

Prognostic Factors ◽

Natural History ◽

Tumor Stage ◽

Population Based ◽

Primary Tumors ◽

Multiple Primary Tumors ◽

Number Of Patients ◽

Multiple Primary ◽

Primary Bladder ◽

Patient’S Outcome

e16138 Background: Carcinosarcoma of the bladder are rare; As a result, few studies of carcinosarcoma of the bladder have included sufficient number of patients to define their natural history and to determine the factors that impact survival. The objective of this study was to examine the epidemiology, natural history, and prognostic factors that affect the survival for carcinosarcoma of the bladder by using population-based registries. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database (1973–2004) was used to identify cases of carcinosarcoma of the bladder by tumor site and histology codes. The association between clinical and demographic characteristics and survival of carcinosarcoma of the bladder was examined. Results: A total of 221 cases of histology confirmed carcinosarcoma of the bladder were identified, this account for approximately 0.11% of primary bladder tumors during same period. By using linked population files, we calculated the incidence of carcinosarcoma of the bladder as a rate 0.22 per 100,000 per year, age-adjusted to year 2000 U.S. standard population. Median age of all patients were 75 years (range 41–96). In about 40% of study population, more than one or multiple primary were also indentified. Majority of (212, 95.9 %) patients received cancer directed surgery. For survival analyses, we excluded the cases that were identified at autopsy or on the basis of death certificates only and the patients have more than one primary. Total 132 patients were included in survival analysis. The median overall survival for all cases was 9 months (range 6–12 months). In multivariate analysis, only tumor stage was found to be significant prognostic factors for disease-specific survival. Conclusions: Carcinosarcoma of the bladder are rare tumors that are challenging, the survival is poor even in patients underwent surgical resection. Better therapy is needed to improve patient's outcome. A significant fraction of carcinosarcoma patients are actually affected by multiple primary tumors, the potential association between carcinosarcoma and other neoplasms remain to be investigated. No significant financial relationships to disclose.

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Younger Age Is an Independent Predictor for Poor Survival in Patients with Signet Ring Prostate Carcinoma

Prostate Cancer ◽

10.1155/2011/216169 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Jue Wang ◽

Fen Wei Wang ◽

George P. Hemstreet

Keyword(s):

Prostate Carcinoma ◽

Survival Rates ◽

Tumor Stage ◽

Advanced Tumor Stage ◽

Cancer Specific Survival ◽

Term Survival ◽

Advanced Tumor ◽

Younger Age ◽

Undifferentiated Histology ◽

Signet Ring

Objective.The aim of this study was to examine the epidemiology, natural history, treatment pattern, and predictors of long-term survival of signet ring prostate carcinoma (SRPC) patients based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database.Methods & Results. Between 1980 and 2004, a total of 93 patients with pathologically confirmed SRPC were identified. The mean age was years old. 82.8% of the patients had poorly or undifferentiated histology grade. 13.9% patients presented with metastatic disease. The 1-, 3-, and 5-year cancer-specific survival rates were 94.6%, 89.6%, and 83.8%, respectively. Using multivariate Cox proportional hazard model, younger age (40–50 versus age >70 yrs, ), advanced tumor stage (distant versus local/regional, ), and earlier diagnosis year (before 1995 versus after 1995, ) were predictors of worse cancer specific survival.Conclusions.Despite more aggressive cancer therapy, younger SRPC patients had a worse cancer specific survival. This information could be useful when counseling these patients and emphasizes the need for new strategies and molecular-based therapeutic approaches for younger patients with SRPC.

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Outcome of Combined Hepatocellular and Cholangiocarcinoma of the Liver

Journal of Oncology ◽

10.1155/2010/917356 ◽

2010 ◽

Vol 2010 ◽

pp. 1-7 ◽

Cited By ~ 23

Author(s):

Jue Wang ◽

Fenwei Wang ◽

Anne Kessinger

Keyword(s):

Logistic Regression ◽

Proportional Hazards ◽

Liver Tumors ◽

Tumor Stage ◽

Population Based ◽

Cox Proportional Hazards ◽

Cancer Specific Survival ◽

Primary Liver Tumors ◽

Combined Hepatocellular And Cholangiocarcinoma ◽

Undifferentiated Histology

Background. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of combined hepatocellular and cholangiocarcinoma (cHCC-CC) using population-based registry.Methods. The Surveillance, Epidemiology, and End Results Program database (1973–2004) was used to identify cases of cHCC-CC. Multivariable logistic regression was used to evaluate factors associated with cancer-directed surgery (CDS). The influence of CDS on cancer specific survival was evaluated using Kaplan-Meier curves and Cox proportional hazards modeling.Results. A total of 380 cases of cHCC-CC were identified, which account for approximately 0.87% of primary liver tumors. Of all patients, 69.8% of patients had regional or distant stage; 65.6% of patients had poorly or undifferentiated histology. Only 44.9% of patients with localized disease, received CDS. By logistic regression analysis, being widowed, advanced stage, and earlier diagnosis year were associated with lower rate of utilization of CDS. In multivariate analysis, tumor stage, receipt of CDS, and recent year of diagnosis were found to be significant predictors for cancer-specific survival.Conclusions. Patients with localized cHCC-CC who are selected for CDS were strongly associated with improved survival. However, many patients with localized tumors did not receive potentially curative cancer-directed surgery. Further study is warranted to address the barriers to the delivery of appropriate care to these patients.

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Primary sarcoma and sarcomatoid carcinoma of the urinary bladder: Comparison of clinical features, treatment, and survival.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.381 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 381-381 ◽

Cited By ~ 1

Author(s):

Jue Wang

Keyword(s):

Multivariate Analysis ◽

Urinary Bladder ◽

Sarcomatoid Carcinoma ◽

High Grade ◽

Optimal Management ◽

Cancer Specific Survival ◽

Tailored Treatment ◽

Stage Disease ◽

History Of ◽

Prognostic Implications

381 Background: Sarcomatoid carcinoma (SaC), sarcoma (SC) and of the urinary bladder are rare entity. As a result, the natural history of these unusual tumors and the optimal management are uncertain. In addition, no previous studies have directly compared the cancer specific survival of patients with SC and SaC to patients with urothelial carcinoma (UC) of the urinary bladder. Methods: Patients with diagnosis of SC, SaC and high grade UC of urinary bladder were identified in the Surveillance, Epidemiology and End Results program (SEER) (1973 to 2012). Demographic of patients and clinical characteristics at diagnosis were compared. Differences in cancer specific survival were compared using univariate and multivariate analysis. Results: A total of 470 patients with SC, 361 with SaC and 58, 835 patients with high grade UC were identified. Patients with SC were younger (p < 0.001), more commonly in female (p < 0.001); black (p < 0.001), and advanced stage disease (p < 0.001), in comparison with patients with high grade UC. On another hand, Patients with SaC were generally older than those with SC and UC. The 5-year cancer specific survival rate was 51.8 % for patients with high grade UC and 36.4% for SC; 32% for SaC. On multivariate analysis there was an increased mortality risk in patients with SaC vs high grade UC. Conclusions: Even after adjusting for demographic, and treatment characteristics, SaC has worst survival than SC and UC. The current finding support bladder cancer is a heterogeneous group of tumors with distinct clinical behavior, distinct prognostic implications, and should receive tailored treatment.

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Impact of gender on the survival of patients with glioblastoma

Bioscience Reports ◽

10.1042/bsr20180752 ◽

2018 ◽

Vol 38 (6) ◽

Cited By ~ 21

Author(s):

Minjie Tian ◽

Wenying Ma ◽

Yueqiu Chen ◽

Yue Yu ◽

Donglin Zhu ◽

...

Keyword(s):

Sex Hormones ◽

Survival Data ◽

Cox Regression ◽

Population Based ◽

Cancer Specific Survival ◽

Term Survival ◽

Kaplan Meier ◽

Male Patients ◽

Stratified Analysis ◽

The Impact

Background: Preclinical models have suggested a role for sex hormones in the development of glioblastoma multiforme (GBM). However, the impact of gender on the survival time of patients with GBM has not been fully understood. The objective of the present study was to clarify the association between gender and survival of patients with GBM by analyzing population-based data. Methods: We searched the Surveillance, Epidemiology, and End-Results database who were diagnosed with GBM between 2000 and 2008 and were treated with surgery. Five-year cancer specific survival data were obtained. Kaplan–Meier methods and multivariable Cox regression models were used to analyze long-term survival outcomes and risk factors. Results: A total of 6586 patients were identified; 61.5% were men and 38.5% were women. The 5-year cancer-specific survival (CSS) rates in the male and female groups were 6.8% and 8.3%, respectively (P=0.002 by univariate and P<0.001 by multivariate analysis). A stratified analysis showed that male patients always had the lowest CSS rate across localized cancer stage and different age subgroups. Conclusions: Gender has prognostic value for determining GBM risk. The role of sex hormones in the development of GBM warrants further investigation.

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PS01.182: TOOLS FOR INDIVIDUALIZED SURVIVAL PREDICTION IN ESOPHAGEAL AND GASTROESOPHAGEAL JUNCTION CANCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.182 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 101-101

Author(s):

Vaibhav Gupta ◽

Natalie Coburn ◽

Biniam Kidane ◽

Kenneth Hess ◽

Carolyn Compton ◽

...

Keyword(s):

Esophageal Cancer ◽

Conflicts Of Interest ◽

Data Extraction ◽

Cell Cancer ◽

Gastroesophageal Junction ◽

Tumor Stage ◽

Survival Prediction ◽

Cancer Specific Survival ◽

Curative Intent ◽

Term Survival

Abstract Background Clinical, pathological and molecular information combined with cancer stage in prognostication algorithms can offer more personalized estimates of survival, which may guide treatment choices. Our aim was to evaluate the quality of prognostication tools in esophageal cancer. Methods We systematically searched MEDLINE & Embase from 2005- 2017 for studies reporting development or validation of models predicting long-term survival in esophageal cancer. We evaluated tools using the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies guidelines and the American Joint Committee on Cancer acceptance criteria for risk models. Results We identified 16 prognostication tools for patients treated with curative intent and one for patients with metastatic disease. These tools frequently excluded adenocarcinoma, contained outdated data and were developed with a limited sample size. Nine tools were developed in China for squamous cell cancer, and 11 used data on patients diagnosed prior to 2010. The majority of tools excluded key prognostic factors such as age and sex. Tumor stage and grade were the most commonly, but not universally, included factors. Twelve tools were designed to predict overall survival; five predicted cancer-specific survival. Bootstrap internal validation was performed for most tools; c-statistics ranged from 0.63–0.77 and graphically evaluated calibration was ‘good’. Five tools were externally validated; c-statistics ranged from 0.70–0.77. Conclusion Existing tools cannot be confidently used for esophageal cancer prognostication in current clinical practice. Better quality tools may help to more individually and accurately estimate disease course, select further treatments, and risk-stratify for future clinical trials. Disclosure All authors have declared no conflicts of interest.

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Endoscopic and Surgical Treatment of T1N0M0 Colorectal Neuroendocrine Tumors: A Population-Based Comparative Study

10.21203/rs.3.rs-34558/v1 ◽

2020 ◽

Author(s):

Hanlong Zhu ◽

Si Zhao ◽

Kun Ji ◽

Wei Wu ◽

Jian Zhou ◽

...

Keyword(s):

Neuroendocrine Tumors ◽

Tumor Size ◽

Proportional Hazards ◽

Population Based ◽

Cox Proportional Hazards ◽

Treatment Modalities ◽

Cancer Specific Survival ◽

Term Survival ◽

Population Based Study

Abstract Background: With the rapid advances in endoscopic technology, endoscopic therapy (ET) is increasingly applied to the treatment of small (≤20 mm) colorectal neuroendocrine tumors (NETs). However, long-term data comparing ET and surgery for management of T1N0M0 colorectal NETs are lacking. The purpose of this work was to compare overall survival (OS) and cancer-specific survival (CSS) of such patients with ET or surgery.Methods: Patients with T1N0M0 colorectal NETs were identified within the Surveillance Epidemiology and End Results (SEER) database (2004-2016). Demographics, tumor characteristics, therapeutic methods, and survival were compared. Propensity score matching (PSM) was used 1:3 and among this cohort, Cox proportional hazards regression models were performed to evaluate correlation between treatment and outcomes.Results: Of 4487 patients with T1N0M0 colorectal NETs, 1125 were identified in the matched cohort, among whom 819 (72.8%) underwent ET and 306 (27.2%) underwent surgery. There was no difference in the 5-year and 10-year OS and CSS rates between the 2 treatment modalities. Likewise, analyses stratified by tumor size and site showed that patients did not benefit more from surgery compared with ET. Moreover, multivariate analyses found no significant differences in OS [Hazard Ratio (HR) = 0.857, 95% Confidence Interval (CI): 0.513–1.431, P = 0.555] and CSS (HR = 0.925, 95% CI: 0.282–3.040, P = 0.898) between the 2 groups. Similar results were observed when comparisons were limited to patients with different tumor size and site.Conclusions: In this population-based study, patients treated endoscopically had comparable long-term survival compared with those treated surgically, which demonstrates ET as an alternative to surgery in T1N0M0 colorectal NETs.

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Surgical Compliance and Survival Outcomes For Patients With Osteosarcoma: A Population-Based Database Study

10.21203/rs.3.rs-754287/v1 ◽

2021 ◽

Author(s):

Chao Tang ◽

Dongdong Wang ◽

Hailong Zhang

Keyword(s):

Logistic Regression Model ◽

Tumor Stage ◽

Population Based ◽

Cancer Specific Survival ◽

Poor Grade ◽

Factors Associated ◽

The Poor ◽

Kaplan Meier ◽

Diagnostic Time ◽

Economic Income

Abstract PurposeWe aimed to determine the effect of surgical compliance on prognosis in patients with osteosarcoma and the risk factors leading to surgical noncompliance.MethodsWe analyzed the date collected 3412 osteosarcoma patients from the Surveillance Epidemiology and End Results (SEER) databases between 1973 and 2015. Cox analyses were used to identify the independent prognostic factors. Logistic regression model was conducted to clear the factors associated to surgical compliance; Kaplan-Meier estimator method was adopted to analyze the Overall survival (OS) and Cancer-specific survival (CSS). ResultsAmong 3412 eligible osteosarcoma patients, the poor surgical compliance of patients with osteosarcoma is associated with the earlier time of diagnosis, advanced age, lower economic income, poor grade, distant stage, accepting radiotherapy and refusing chemotherapy. There were significant differences in the effects of diagnostic time, age, grade, radiotherapy, chemotherapy, tumor stage and economic income on surgical compliance (All P < 0.05). Patients’ compliance was an independent prognostic factor for OS and CSS of osteosarcoma patients. ConclusionsOsteosarcoma patients with good surgical compliance have favorable survival. This can help clinicians effectively realize patients' views on surgery and guide patients to learn the signification of surgery.

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