Pattern of Distant Metastases and Promising Prognostic Factors in Bladder Cancer: A Population-Based Study
Journal of Cancer Treatment and Research
Volume 8, Issue 1, March 2020, Pages: 1-9
Received: Dec. 19, 2019; Accepted: Dec. 30, 2019; Published: Jan. 8, 2020
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Yanbo Xu, Department of Surgical Oncology, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
Hong Liu, Department of Medical Oncology, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
Yue Liu, Department of Surgical Oncology, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
Qihua Cao, Department of Surgical Oncology, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
Dong Xu, Department of Surgical Oncology and Cancer Institute, the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
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The aims of this study were to evaluate the incidence and survival rates of distant metastases in newly diagnosed bladder cancer patients, and to investigate the risk and prognostic factors as well. The Surveillance, Epidemiology, and End Results (SEER) database was analyzed for the incidence and survival rates of patients diagnosed with bladder cancer between 2010–2015. Multivariate logistic regression analyses identified risk factors for distant metastases. The survival rates were calculated by Kaplan Meier analysis. Cox regression and Fine and Grey’s model analyses were used to estimate prognostic factors associated with metastatic bladder cancers. Totally, there were 65541 patients with bladder cancer obtained from the SEER database, and 2812 were diagnosed with distant metastases on initial diagnosis (4.3%). Metastatic distribution information was concluded liver, lung, bone, brain and others. Of these, 1029 patients were bone metastases, 988 patients were lung metastases, 687 patients were liver metastases and 97 patients were brain metastases. As a result, younger age, unmarried social status, Black race, non-transitional cell carcinoma subtypes, poor differentiated grade, increased tumor stage and lymph node stage, absence of surgery to primary sites or unknown were all significantly associated with early distant metastases by logistic regression. Multivariate Cox regression analysis showed that older age, female, unmarried social status, non-TCC subtypes, increased number of metastatic sites and absence of surgery to primary sites were significantly associated with reduced overall survival. These findings in metastatic bladder cancer may help to arrange thorough evaluation and then make individualized treatment plan.
Bladder Cancer, Metastasis, Incidence, Prognosis
To cite this article
Yanbo Xu, Hong Liu, Yue Liu, Qihua Cao, Dong Xu, Pattern of Distant Metastases and Promising Prognostic Factors in Bladder Cancer: A Population-Based Study, Journal of Cancer Treatment and Research. Vol. 8, No. 1, 2020, pp. 1-9. doi: 10.11648/j.jctr.20200801.11
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Siegel RL, Miller KD. Cancer statistics, 2019. CA Cancer J Clin. 2019; 69 (1): 7-34.
Lynch CF, Davila JA, Platz CE. Cancer of the urinary bladder. In: Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J, Eds. SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. New York: NIH Pub, 2007, pp. 181-192.
Dong F, Shen Y, Gao F, Xu T, Wang X, Zhang X, Zhong, S, Zhang, M, Chen, S, et al. Prognostic value of site-specific metastases and therapeutic roles of surgery for patients with metastatic bladder cancer: a population-based study. Cancer Manag Research. 2017; 9: 611-626.
Huang P, Lan M, Peng AF, Yu QF, Chen WZ, Liu ZL, Liu JM, Huang SH. Serum calcium, alkaline phosphotase and hemoglobin as risk factors for bone metastases in bladder cancer. PloS one. 2017; 12 (9): e0183835.
Rosenberg JE, Carroll PR, Small EJ. Update on chemotherapy for advanced bladder cancer. J Urol. 2005; 174 (1): 14-20.
Matos J, Mussetto I, Podesta R, Schettini D, Gandolfo N. Bladder cancer presenting with acrometastases: a different cause of foot pain. Skeletal Radiol. 2018; 47 (7): 1003-1009.
Klaassen Z, DiBianco JM, Jen RP, Evans AJ, Reinstatler L, Terris MK, Madi R. Female, Black, and Unmarried Patients Are More Likely to Present With Metastatic Bladder Urothelial Carcinoma. Clin Genitourin cancer. 2016; 14 (5): e489-e492.
Bianchi M, Roghmann F, Becker A, Sukumar S, Briganti A, Menon M, Karakiewicz PI, Sun, M, Noldus J, et al. Age-stratified distribution of metastatic sites in bladder cancer: A population-based analysis. Can Urol Assoc J. 2014; 8 (3-4): E148-158.
Chen C, Hu LK, Chen Y, Hou JQ. The prognostic value of histological subtype in patients with metastatic bladder cancer. Oncotarget. 2017; 8 (17): 28408-28417.
Sengeløv L, Kamby C, von der Maase H. Pattern of metastases in relation to characteristics of primary tumor and treatment in patients with disseminated urothelial carcinoma. Journal urol. 1996; 155 (1): 111-114.
Prout GR, Wesley MN, Greenberg RS, Chen VW, Brown CC, Miller AW, Weinstein RS, Robboy SJ, Haynes MA, et al. Bladder cancer: race differences in extent of disease at diagnosis. Cancer. 2000; 89 (6): 1349-1358.
Wallmeroth A, Wagner U, Moch H, Gasser TC, Sauter G, Mihatsch MJ. Patterns of metastasis in muscle-invasive bladder cancer (pT2-4): An autopsy study on 367 patients. Urol Int. 1999; 62 (2): 69-75.
Shinagare AB, Ramaiya NH, Jagannathan JP, Fennessy FM, Taplin ME, Van den Abbeele AD. Metastatic pattern of bladder cancer: correlation with the characteristics of the primary tumor. AJR Am J Roentgenol. 2011; 196 (1): 117-122.
Abe T, Kitamura H, Obara W, Matsumura N, Tsukamoto T, Fujioka T, Hara I, Murai S, Shinohara N, et al. Outcome of metastasectomy for urothelial carcinoma: a multi-institutional retrospective study in Japan. J Urol. 2014; 191 (4): 932-936.
Otto T, Krege S, Suhr J, Rübben H. Impact of surgical resection of bladder cancer metastases refractory to systemic therapy on performance score: a phase II trial. Urology. 2001; 57 (1): 55-59.
Anderson RS, el-Mahdi AM, Kuban DA, Higgins EM. Brain metastases from transitional cell carcinoma of urinary bladder. Urology. 1992; 39 (1): 17-20.
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