Multiple primary tumors in patients with carcinosarcoma of bladder: A coincidence or an etiological association? A study of 221 carcinosarcoma of bladder cases

Abstract

e16138 Background: Carcinosarcoma of the bladder are rare; As a result, few studies of carcinosarcoma of the bladder have included sufficient number of patients to define their natural history and to determine the factors that impact survival. The objective of this study was to examine the epidemiology, natural history, and prognostic factors that affect the survival for carcinosarcoma of the bladder by using population-based registries. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program database (1973–2004) was used to identify cases of carcinosarcoma of the bladder by tumor site and histology codes. The association between clinical and demographic characteristics and survival of carcinosarcoma of the bladder was examined. Results: A total of 221 cases of histology confirmed carcinosarcoma of the bladder were identified, this account for approximately 0.11% of primary bladder tumors during same period. By using linked population files, we calculated the incidence of carcinosarcoma of the bladder as a rate 0.22 per 100,000 per year, age-adjusted to year 2000 U.S. standard population. Median age of all patients were 75 years (range 41–96). In about 40% of study population, more than one or multiple primary were also indentified. Majority of (212, 95.9 %) patients received cancer directed surgery. For survival analyses, we excluded the cases that were identified at autopsy or on the basis of death certificates only and the patients have more than one primary. Total 132 patients were included in survival analysis. The median overall survival for all cases was 9 months (range 6–12 months). In multivariate analysis, only tumor stage was found to be significant prognostic factors for disease-specific survival. Conclusions: Carcinosarcoma of the bladder are rare tumors that are challenging, the survival is poor even in patients underwent surgical resection. Better therapy is needed to improve patient's outcome. A significant fraction of carcinosarcoma patients are actually affected by multiple primary tumors, the potential association between carcinosarcoma and other neoplasms remain to be investigated. No significant financial relationships to disclose.