Differences in Survival Among Patients With Sarcomatoid Carcinoma, Carcinosarcoma and Urothelial Carcinoma of the Bladder

No AccessJournal of UrologyAdult urology1 Dec 2007Differences in Survival Among Patients With Sarcomatoid Carcinoma, Carcinosarcoma and Urothelial Carcinoma of the Bladder Jonathan L. Wright, Peter C. Black, Gordon A. Brown, Michael P. Porter, Ashish M. Kamat, Colin P. Dinney, and Daniel W. Lin Jonathan L. WrightJonathan L. Wright Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author , Peter C. BlackPeter C. Black Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author , Gordon A. BrownGordon A. Brown Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author , Michael P. PorterMichael P. Porter Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author , Ashish M. KamatAshish M. Kamat Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author , Colin P. DinneyColin P. Dinney Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas Financial interest and/or other relationship with AstraZeneca, GlaxoSmithKline, Canji/Schering-Plough, Abbott/Vysis, Novartis, SciMed, Bristol-Myers Squibb and Physicians’ Education Resource. More articles by this author , and Daniel W. LinDaniel W. Lin Department of Urology, University of Washington School of Medicine, Seattle, Washington Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.08.038AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Sarcomatoid carcinoma and carcinosarcoma of the bladder are rare tumors that contain epithelial and mesenchymal elements, and may portend a worse prognosis than conventional urothelial carcinoma. We investigated the survival of patients with the 2 tumor subtypes compared to survival in those with urothelial carcinoma. Materials and Methods: Cases of sarcomatoid carcinoma, carcinosarcoma and high grade urothelial carcinoma of the bladder were identified from the Surveillance, Epidemiology and End Results Program. Demographic and pathological characteristics were compared. Differences in survival based on histological subtype were estimated using Kaplan-Meier analysis and multivariate Cox proportional hazards regression. Results: Overall unadjusted survival rates for 46,515 patients with urothelial carcinoma, 135 with sarcomatoid carcinoma and 166 with carcinosarcoma were 77%, 54% and 48% at 1 year, and 47%, 37% and 17% at 5 years, respectively. Sarcomatoid carcinoma and carcinosarcoma presented at a similar age but at a higher T stage and with more frequent regional and distant metastases compared to urothelial carcinoma. On multivariate analysis patients with sarcomatoid carcinoma (HR 1.18, 95% CI 0.91–1.52) and carcinosarcoma (HR 2.00, 95% CI 1.65–2.41) were at higher risk for death compared to those with urothelial carcinoma. Overall mortality was worse with carcinosarcoma than with sarcomatoid carcinoma (HR 1.70, 95% CI 1.23–2.34). Conclusions: Compared to patients with urothelial carcinoma those with sarcomatoid carcinoma and carcinosarcoma present at a more advanced stage and are at greater risk for death even after adjusting for stage at presentation. The survival rate of sarcomatoid carcinoma is better than that of carcinosarcoma, offering some justification for the continued differentiation of these tumor types for clinical prognostication. References 1 : Malignant non-urothelial neoplasms of the urinary bladder: a review. Eur Urol2003; 44: 672. Google Scholar 2 : Clinical outcomes following radical cystectomy for primary nontransitional cell carcinoma of the bladder compared to transitional cell carcinoma of the bladder. J Urol2006; 175: 2048. Link, Google Scholar 3 : Sarcomatoid carcinoma of the urinary bladder: a clinicopathologic and immunohistochemical analysis of 14 patients. Hum Pathol2000; 31: 332. 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Volume 178Issue 6December 2007Page: 2302-2307 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordscarcinomacarcinosarcomabladder neoplasmsmortalitybladderMetricsAuthor Information Jonathan L. Wright Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author Peter C. Black Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author Gordon A. Brown Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author Michael P. Porter Department of Urology, University of Washington School of Medicine, Seattle, Washington More articles by this author Ashish M. Kamat Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas More articles by this author Colin P. Dinney Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas Financial interest and/or other relationship with AstraZeneca, GlaxoSmithKline, Canji/Schering-Plough, Abbott/Vysis, Novartis, SciMed, Bristol-Myers Squibb and Physicians’ Education Resource. More articles by this author Daniel W. Lin Department of Urology, University of Washington School of Medicine, Seattle, Washington Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington More articles by this author Expand All Advertisement PDF downloadLoading ...