Analysis of Clinicopathological Characteristics and Factors Affecting the Prognosis of Patients With Resectable Sarcomatoid Carcinoma of the Bladder

HUANG Shiwang; JIA Kaipeng; SHEN Chong; CHEN Huitong; ZHANG Zhe; WU Zhouliang; QIE Yunkai; GUO Jianing; HU Hailong

doi:10.12182/20240960102

Volume 55 Issue 5

Oct. 2024

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JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCES) > 2024 > 55(5): 1085-1091. > DOI: 10.12182/20240960102

HUANG Shiwang, JIA Kaipeng, SHEN Chong, et al. Analysis of Clinicopathological Characteristics and Factors Affecting the Prognosis of Patients With Resectable Sarcomatoid Carcinoma of the Bladder[J]. Journal of Sichuan University (Medical Sciences), 2024, 55(5): 1085-1091. DOI: 10.12182/20240960102

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Analysis of Clinicopathological Characteristics and Factors Affecting the Prognosis of Patients With Resectable Sarcomatoid Carcinoma of the Bladder

HUANG Shiwang^{1, 2,},
JIA Kaipeng^{1, 2},
SHEN Chong^{1, 2},
CHEN Huitong^{1, 2},
ZHANG Zhe^{1, 2},
WU Zhouliang^{1, 2},
QIE Yunkai^{1, 2},
GUO Jianing³,
HU Hailong^{1, 2, ,}

1.
Department of Urology, Second Hospital of Tianjin Medical University, Tianjin 300211, China
2.
Tianjin Institute of Urology, Tianjin 300211, China
3.
Department of Pathology, Second Hospital of Tianjin Medical University, Tianjin 300211, China

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Corresponding author:
HU Hailong, E-mail: huhailong@tmu.edu.cn
Received Date: April 20, 2024
Revised Date: August 19, 2024
Published Date: September 19, 2024

Abstract

Abstract

Objective
To investigate the clinicopathological characteristics and the factors affecting the prognosis of patients with resectable sarcomatoid carcinoma of the bladder (SCB).
Methods
A retrospective analysis was conducted with the clinical data of patients with resectable SCB treated at the Second Hospital of Tianjin Medical University between September 2008 and December 2023. The patients were divided into two groups, a bladder-preserving surgery (BPS) group and a radical cystectomy (RC) group, according to the specific surgical approach used for each patient. Kaplan-Meier survival curves were used to evaluate overall survival (OS) in both groups, and Cox regression models were employed to identify risk factors affecting survival.
Results
A total of 77 patients with resectable SCB were included. Among them, 35 patients (45.5%) underwent BPS, while 42 patients (54.5%) underwent RC. Ki-67 expression≥30% was observed in 91.7% of the patients. A total of 92.2% of the patients was tested positive for cytokeratin (CK) and 98.1% for vimentin. In addition, 62.5% and 37.5% of patients had the human epidermal growth factor receptor 2 (Her-2) scores of 0 and 1+, respectively. The median follow-up time was 23.2 months (ranging from 0.4 to 164.7 months). The 1-year, 3-year, and 5-year survival rates for the BPS group and the RC group were as follows, 76.2% vs. 84.9%, 46.7% vs. 61.1%, and 35.6% vs. 43.2%, respectively. Multivariate Cox regression analysis revealed that in the RC group, age≥75 years old (hazard ratio [HR]=3.836, 95% confidence interval [CI]: 1.168-12.595, P=0.027), tumor multiplicity (HR=3.439, 95% CI: 1.235-9.574, P=0.018), and lack of adjuvant therapy (HR=3.164, 95% CI: 1.015-9.862, P=0.047) were independent risk factors affecting survival. In the BPS group, female sex was identified as an independent risk factor for survival (HR=3.601, 95% CI: 1.200-10.804, P=0.022).
Conclusion
Ki-67, CK, and vimentin are significantly overexpressed in SCB patients, while Her-2 is either unexpressed or expressed at low levels. In the RC group, tumor multiplicity, age ≥75 years, and lack of postoperative adjuvant therapy are independent risk factors for overall survival. Female sex is an independent risk factor affecting prognosis in the BPS group.
- Urinary bladder,
- Sarcomatoid carcinoma,
- Prognosis,
- Retrospective studies,
- Risk factors

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Analysis of Clinicopathological Characteristics and Factors Affecting the Prognosis of Patients With Resectable Sarcomatoid Carcinoma of the Bladder

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