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Comparison Between Urothelial and Non-Urothelial Urethral Cancer

M. Wenzel, M. Deuker, L. Nocera, C. Collà Ruvolo, Z. Tian, SF. Shariat, F. Saad, A. Briganti, A. Becker, LA. Kluth, FKH. Chun, PI. Karakiewicz

. 2020 ; 10 (-) : 629692. [pub] 20210129

Language English Country Switzerland

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc21010574

Background: To test the effect of variant histology relative to urothelial histology on stage at presentation, cancer specific mortality (CSM), and overall mortality (OM) after chemotherapy use, in urethral cancer. Materials and Methods: Within the Surveillance, Epidemiology and End Results (2004-2016) database, we identified 1,907 primary variant histology urethral cancer patients. Kaplan-Meier plots, Cox regression analyses, cumulative incidence-plots, multivariable competing-risks regression models and propensity score matching for patient and tumor characteristics were used. Results: Of 1,907 eligible urethral cancer patients, urothelial histology affected 1,009 (52.9%) vs. squamous cell carcinoma (SCC) 455 (23.6%) vs. adenocarcinoma 278 (14.6%) vs. other histology 165 (8.7%) patients. Urothelial histological patients exhibited lower stages at presentation than SCC, adenocarcinoma or other histology patients. In urothelial histology patients, five-year CSM was 23.5% vs. 34.4% in SCC [Hazard Ratio (HR) 1.57] vs. 40.7% in adenocarcinoma (HR 1.69) vs. 43.4% in other histology (HR 1.99, p < 0.001). After matching in multivariate competing-risks regression models, variant histology exhibited 1.35-fold higher CSM than urothelial. Finally, in metastatic urethral cancer, lower OM was recorded after chemotherapy in general, including metastatic adenocarcinoma and other variant histology subtypes, except metastatic SCC. Conclusion: Adenocarcinoma, SCC and other histology subtypes affect fewer patients than urothelial histology. Presence of variant histology results in higher CSM. Finally, chemotherapy for metastatic urethral cancer improves survival in adenocarcinoma and other variant histology subtypes, but not in SCC.

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$a Wenzel, Mike $u Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany ; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
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$a Comparison Between Urothelial and Non-Urothelial Urethral Cancer / $c M. Wenzel, M. Deuker, L. Nocera, C. Collà Ruvolo, Z. Tian, SF. Shariat, F. Saad, A. Briganti, A. Becker, LA. Kluth, FKH. Chun, PI. Karakiewicz
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$a Background: To test the effect of variant histology relative to urothelial histology on stage at presentation, cancer specific mortality (CSM), and overall mortality (OM) after chemotherapy use, in urethral cancer. Materials and Methods: Within the Surveillance, Epidemiology and End Results (2004-2016) database, we identified 1,907 primary variant histology urethral cancer patients. Kaplan-Meier plots, Cox regression analyses, cumulative incidence-plots, multivariable competing-risks regression models and propensity score matching for patient and tumor characteristics were used. Results: Of 1,907 eligible urethral cancer patients, urothelial histology affected 1,009 (52.9%) vs. squamous cell carcinoma (SCC) 455 (23.6%) vs. adenocarcinoma 278 (14.6%) vs. other histology 165 (8.7%) patients. Urothelial histological patients exhibited lower stages at presentation than SCC, adenocarcinoma or other histology patients. In urothelial histology patients, five-year CSM was 23.5% vs. 34.4% in SCC [Hazard Ratio (HR) 1.57] vs. 40.7% in adenocarcinoma (HR 1.69) vs. 43.4% in other histology (HR 1.99, p < 0.001). After matching in multivariate competing-risks regression models, variant histology exhibited 1.35-fold higher CSM than urothelial. Finally, in metastatic urethral cancer, lower OM was recorded after chemotherapy in general, including metastatic adenocarcinoma and other variant histology subtypes, except metastatic SCC. Conclusion: Adenocarcinoma, SCC and other histology subtypes affect fewer patients than urothelial histology. Presence of variant histology results in higher CSM. Finally, chemotherapy for metastatic urethral cancer improves survival in adenocarcinoma and other variant histology subtypes, but not in SCC.
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$a Deuker, Marina $u Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany ; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
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$a Nocera, Luigi $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada ; Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
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$a Collà Ruvolo, Claudia $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada ; Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
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$a Tian, Zhe $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
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$a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Departments of Urology, Weill Cornell Medical College, New York, NY, United States $u Department of Urology, University of Texas Southwestern, Dallas, TX, United States $u Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia $u Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia $u Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
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$a Saad, Fred $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
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$a Briganti, Alberto $u Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
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$a Becker, Andreas $u Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
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$a Kluth, Luis A $u Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
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$a Chun, Felix K H $u Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
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$a Karakiewicz, Pierre I $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
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