Age-stratified distribution of metastatic sites in bladder cancer: A population-based analysis

TY - JOUR

T1 - Age-stratified distribution of metastatic sites in bladder cancer: A population-based analysis

AU - Bianchi, Marco

AU - Roghmann, Florian

AU - Becker, Andreas

AU - Sukumar, Shyam

AU - Briganti, Alberto

AU - Menon, Mani

AU - Karakiewicz, Pierre I

AU - Sun, Maxine

AU - Noldus, Joachim

AU - Trinh, Quoc-Dien

PY - 2014/3/1

Y1 - 2014/3/1

N2 - INTRODUCTION: Urothelial carcinoma of the urinary bladder (UCUB) is the most common malignancy of the urinary tract. We examined the distribution of site-specific metastases in patients with UCUB according to age and we assessed contemporary recommendations proposed by guidelines with regard to distant metastases.METHODS: Patients with metastatic UCUB (mUCUB) were abstracted from the Nationwide Inpatient Sample (1998-2007). Age was stratified into quartiles: ≤63, 64-72, 73-79 and ≥80 years. Cochran-Armitage trend test and multivariable logistic regression analysis tested the relationship between age and the rate of metastases. Finally, we identified patients at high risk of brain or bone metastases.RESULTS: Within 7543 patients with mUCUB, 25%, 24%, 23%, 19%, 18% and 3% had lymph node, bone, urinary, lung and liver metastases, respectively. Overall, the rate of concomitant metastases was 29%. The rate of multiple metastatic sites decreased with increasing age (p < 0.001). This was confirmed in patients with lung, bone, liver, urinary system and brain metastases (all p ≤ 0.04). The rate of bone metastases was 15.0% in patients with exclusive abdominal metastases and 40.0% in patients with abdominal, thoracic and brain metastases. The rate of brain metastases was 1% in patients with exclusive abdominal metastases and 7% in patients with thoracic and bone metastases. Our findings are limited by the retrospective nature of the analyses.CONCLUSIONS: We report a higher number of concomitant metastatic sites in young UCUB patients. Bone metastases are frequent in all patient groups, whereas brain metastases are common in UCUB patients with thoracic and/or bone metastases.

AB - INTRODUCTION: Urothelial carcinoma of the urinary bladder (UCUB) is the most common malignancy of the urinary tract. We examined the distribution of site-specific metastases in patients with UCUB according to age and we assessed contemporary recommendations proposed by guidelines with regard to distant metastases.METHODS: Patients with metastatic UCUB (mUCUB) were abstracted from the Nationwide Inpatient Sample (1998-2007). Age was stratified into quartiles: ≤63, 64-72, 73-79 and ≥80 years. Cochran-Armitage trend test and multivariable logistic regression analysis tested the relationship between age and the rate of metastases. Finally, we identified patients at high risk of brain or bone metastases.RESULTS: Within 7543 patients with mUCUB, 25%, 24%, 23%, 19%, 18% and 3% had lymph node, bone, urinary, lung and liver metastases, respectively. Overall, the rate of concomitant metastases was 29%. The rate of multiple metastatic sites decreased with increasing age (p < 0.001). This was confirmed in patients with lung, bone, liver, urinary system and brain metastases (all p ≤ 0.04). The rate of bone metastases was 15.0% in patients with exclusive abdominal metastases and 40.0% in patients with abdominal, thoracic and brain metastases. The rate of brain metastases was 1% in patients with exclusive abdominal metastases and 7% in patients with thoracic and bone metastases. Our findings are limited by the retrospective nature of the analyses.CONCLUSIONS: We report a higher number of concomitant metastatic sites in young UCUB patients. Bone metastases are frequent in all patient groups, whereas brain metastases are common in UCUB patients with thoracic and/or bone metastases.

U2 - 10.5489/cuaj.787

DO - 10.5489/cuaj.787

M3 - SCORING: Journal article

C2 - 24678354

VL - 8

SP - E148-E158

JO - CUAJ-CAN UROL ASSOC

JF - CUAJ-CAN UROL ASSOC

SN - 1911-6470

IS - 3-4

ER -