Primary sarcoma and sarcomatoid carcinoma of the urinary bladder: Comparison of clinical features, treatment, and survival.

Abstract

381 Background: Sarcomatoid carcinoma (SaC), sarcoma (SC) and of the urinary bladder are rare entity. As a result, the natural history of these unusual tumors and the optimal management are uncertain. In addition, no previous studies have directly compared the cancer specific survival of patients with SC and SaC to patients with urothelial carcinoma (UC) of the urinary bladder. Methods: Patients with diagnosis of SC, SaC and high grade UC of urinary bladder were identified in the Surveillance, Epidemiology and End Results program (SEER) (1973 to 2012). Demographic of patients and clinical characteristics at diagnosis were compared. Differences in cancer specific survival were compared using univariate and multivariate analysis. Results: A total of 470 patients with SC, 361 with SaC and 58, 835 patients with high grade UC were identified. Patients with SC were younger (p < 0.001), more commonly in female (p < 0.001); black (p < 0.001), and advanced stage disease (p < 0.001), in comparison with patients with high grade UC. On another hand, Patients with SaC were generally older than those with SC and UC. The 5-year cancer specific survival rate was 51.8 % for patients with high grade UC and 36.4% for SC; 32% for SaC. On multivariate analysis there was an increased mortality risk in patients with SaC vs high grade UC. Conclusions: Even after adjusting for demographic, and treatment characteristics, SaC has worst survival than SC and UC. The current finding support bladder cancer is a heterogeneous group of tumors with distinct clinical behavior, distinct prognostic implications, and should receive tailored treatment.