1872 DISTRIBUTION OF METASTATIC SITES IN BLADDER CANCER: A POPULATION-BASED ANALYSIS

Abstract

You have accessJournal of UrologyBladder Cancer: Metastatic Disease + Staging1 Apr 20131872 DISTRIBUTION OF METASTATIC SITES IN BLADDER CANCER: A POPULATION-BASED ANALYSIS Al'a Abdo, Marco Bianchi, Florian Roghmann, Andreas Becker, Malek Meskawi, Zhe Tian, Nawar Hanna, Pierre I Karakiewicz, Maxine Sun, and Quoc-Dien Trinh Al'a AbdoAl'a Abdo Montreal, Canada More articles by this author , Marco BianchiMarco Bianchi Milan, Italy More articles by this author , Florian RoghmannFlorian Roghmann Herne, Germany More articles by this author , Andreas BeckerAndreas Becker Hamburg, Germany More articles by this author , Malek MeskawiMalek Meskawi Montreal, Canada More articles by this author , Zhe TianZhe Tian Montreal, Canada More articles by this author , Nawar HannaNawar Hanna Montreal, Canada More articles by this author , Pierre I KarakiewiczPierre I Karakiewicz Montreal, Canada More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2291AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The distribution pattern of metastases in urothelial carcinoma of the urinary bladder (UCUB) is relatively unknown. Based on these considerations, we examined the distribution of site-specific metastases in patients with mUCUB according to age and to assess contemporary recommendations proposed by guidelines with regard to distant metastases. METHODS Overall, 7543 patients with metastatic mUCUB were abstracted from the Nationwide Inpatient Sample (1998-2007). Age was stratified according to quartiles into four groups: ≤63, 64-72, 73-79 and ≥80 years. Cochran-Armitage trend test and multivariable logistic regression analysis (adjusted for gender, race, and CCI) tested the relationship between age and the rate of metastases. Finally, we attempted to identify patients at high risk of harboring brain or bone metastases. RESULTS Within 7543 patients with mUCUB, 25, 24, 23, 19 and 18% had lymph node, bone, urinary, lung, and liver metastases, respectively. Overall, the rate of brain metastases was 3%. The rate of multiple metastatic sites decreased with increasing age (p<0.001). For example, in patients aged ≤63, 64-72, 73-79, and ≥80 years, the rate of multiple metastatic sites was 33, 31, 28, and 23%, respectively (p<0.001). This phenomenon was confirmed in patients with lung, bone, liver, urinary system and brain metastases (all p≤0.04). In multivariable analyses, young age represented an independent predictor of the presence multiple concomitant metastatic sites in the entire population (odds ratio: 1.3, p<0.001). Exclusive bone and brain metastases were 13 and 1.2% amongst all mUCUB individuals. 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 bone metastases in the remainder of the population ranged from 18 to 30%. The rate of brain metastases was 1% in patients with exclusive abdominal metastases and 7% in patients with thoracic and bone metastases. The rate of brain metastases in the remainder of the population ranged from 2 to 6%. CONCLUSIONS We report a higher number of concomitant metastatic sites in young patients. Bone metastases are frequent in all patients groups and require routine assessment. Brain metastases are common in patients with thoracic and/or bone metastases. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e768 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Al'a Abdo Montreal, Canada More articles by this author Marco Bianchi Milan, Italy More articles by this author Florian Roghmann Herne, Germany More articles by this author Andreas Becker Hamburg, Germany More articles by this author Malek Meskawi Montreal, Canada More articles by this author Zhe Tian Montreal, Canada More articles by this author Nawar Hanna Montreal, Canada More articles by this author Pierre I Karakiewicz Montreal, Canada More articles by this author Maxine Sun Montreal, Canada More articles by this author Quoc-Dien Trinh Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...