Metastatic Tropism in Urothelial Carcinoma With Variant Histology: A Comprehensive NCDB Analysis

IF 2.3 3区 医学 Q3 ONCOLOGY
Arthur Drouaud, Vincent Xu, Alejandro Velasquez, Ryan Antar, Brandon Boyarsky, Jacob Weiss, Diego Gonzalez, Rachel Silverman, Michael J Whalen
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Abstract

Introduction

Bladder cancer (BCa) with variant histology (VH) is notably aggressive and not as well studied as pure urothelial carcinoma (UC). The characteristics of variant BCa in the setting of metastatic disease may contribute to treatment response/resistance and subsequent disease progression. In this study, we sought to assess VH's impact on metastasis sites at presentation in metastatic BCa.

Methods

The National Cancer Database was queried from 2004 to 2019 to analyze cT1-4 cN0-3 cM1 patients with UC and VH BCa. The primary endpoint was the presence of metastasis to different organs. Binomial multivariable logistic regression was performed to determine the impact of VH on metastatic sites while controlling for multiple variables.

Results

Total 6005 eligible patients diagnosed with either UC or VH were included. Patients with small cell histology, the second most common VH, were more likely to have liver metastasis (OR: 4.335) while less likely to have lung metastases (OR: 0.521). Squamous cell carcinoma decreased the odds of bone metastasis (OR: 0.449). Adenocarcinoma increased the odds of lung metastases (OR: 1.690). Micropapillary VH is less likely to metastasize to the lungs (OR: 0.182) but more likely to spread to nonregional lymph nodes (OR: 2.623). Sarcomatoid subtype did not exhibit a statistically significant variation in the odds ratio for any of the metastatic sites.

Conclusion

This study comprehensively analyzes the limited research regarding metastatic BCa and VH. Our analysis underscores each subtype exhibiting heterogeneous metastatic tropism. Importantly, these findings illustrate the role of routine somatic gene expression profiling to guide adequate staging and treatment intensification and to offer a foundation for future studies of VH BCa care.

变异组织学尿路上皮癌的转移倾向:NCDB 综合分析
导言:变异组织学(VH)膀胱癌(BCa)具有明显的侵袭性,对其的研究不如纯尿路上皮癌(UC)深入。变异组织学膀胱癌(BCa)在转移性疾病中的特征可能会导致治疗反应/耐药性和随后的疾病进展。在这项研究中,我们试图评估VH对转移性BCa发病时转移部位的影响。方法查询了2004年至2019年的美国国家癌症数据库,分析了患有UC和VH BCa的cT1-4 cN0-3 cM1患者。主要终点是出现不同器官的转移。在控制多种变量的情况下,进行了二项式多变量逻辑回归,以确定VH对转移部位的影响。小细胞组织学是第二常见的VH,其患者更有可能发生肝转移(OR:4.335),而肺转移的可能性较小(OR:0.521)。鳞状细胞癌降低了骨转移的几率(OR:0.449)。腺癌会增加肺转移的几率(OR:1.690)。微乳头状 VH 转移到肺部的几率较低(OR:0.182),但转移到非区域淋巴结的几率较高(OR:2.623)。本研究全面分析了有关转移性 BCa 和 VH 的有限研究。我们的分析强调了每种亚型都表现出异质性转移倾向。重要的是,这些发现说明了常规体细胞基因表达谱分析在指导适当的分期和强化治疗方面的作用,并为今后的 VH BCa 护理研究奠定了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical genitourinary cancer
Clinical genitourinary cancer 医学-泌尿学与肾脏学
CiteScore
5.20
自引率
6.20%
发文量
201
审稿时长
54 days
期刊介绍: Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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