Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar-Apr;8(3-4):E148-58.
doi: 10.5489/cuaj.787.

Age-stratified distribution of metastatic sites in bladder cancer: A population-based analysis

Marco Bianchi  1 , Florian Roghmann  2 , Andreas Becker  3 , Shyam Sukumar  4 , Alberto Briganti  5 , Mani Menon  4 , Pierre I Karakiewicz  6 , Maxine Sun  7 , Joachim Noldus  8 , Quoc-Dien Trinh  4
Affiliations

Age-stratified distribution of metastatic sites in bladder cancer: A population-based analysis

Marco Bianchi et al. Can Urol Assoc J. 2014 Mar-Apr.

Abstract

Introduction: Urothelial carcinoma of the urinary bladder (UCUB) is the most common malignancy of the urinary tract. We examined the distribution of site-specific metastases in patients with UCUB according to age and we assessed contemporary recommendations proposed by guidelines with regard to distant metastases.

Methods: Patients with metastatic UCUB (mUCUB) were abstracted from the Nationwide Inpatient Sample (1998-2007). Age was stratified into quartiles: ≤63, 64-72, 73-79 and ≥80 years. Cochran-Armitage trend test and multivariable logistic regression analysis tested the relationship between age and the rate of metastases. Finally, we identified patients at high risk of brain or bone metastases.

Results: Within 7543 patients with mUCUB, 25%, 24%, 23%, 19%, 18% and 3% had lymph node, bone, urinary, lung and liver metastases, respectively. Overall, the rate of concomitant metastases was 29%. The rate of multiple metastatic sites decreased with increasing age (p < 0.001). This was confirmed in patients with lung, bone, liver, urinary system and brain metastases (all p ≤ 0.04). 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 brain metastases was 1% in patients with exclusive abdominal metastases and 7% in patients with thoracic and bone metastases. Our findings are limited by the retrospective nature of the analyses.

Conclusions: We report a higher number of concomitant metastatic sites in young UCUB patients. Bone metastases are frequent in all patient groups, whereas brain metastases are common in UCUB patients with thoracic and/or bone metastases.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
The distribution of metastatic sites in patients with bladder cancer (n = 7543), Nationwide Inpatient Sample, 1998–2007 (the rates add up to more than 100% because some patients have multiple metastatic sites).
Fig. 2.
Fig. 2.
The distribution of metastases in a single versus multiple concomitant sites, stratified according to age categories (n = 7543) (p < 0.001).
Fig. 3a.
Fig. 3a.
The distribution of metastases in a single versus multiple concomitant sites, stratified according to age categories, in the bone.
Fig. 3b.
Fig. 3b.
The distribution of metastases in a single versus multiple concomitant sites, stratified according to age categories, in the brain.
Fig. 3c.
Fig. 3c.
The distribution of metastases in a single versus multiple concomitant sites, stratified according to age categories, in the liver.
Fig. 3d.
Fig. 3d.
The distribution of metastases in a single versus multiple concomitant sites, stratified according to age categories, in the lymph nodes.
Fig. 3e.
Fig. 3e.
The distribution of metastases in a single versus multiple concomitant sites, stratified according to age categories, in the lungs.
Fig. 3f.
Fig. 3f.
The distribution of metastases in a single versus multiple concomitant sites, stratified according to age categories, in the urinary tract.
Fig. 4.
Fig. 4.
The rates of bone metastases according to the presence of other established synchronous metastatic sites.
Fig. 5.
Fig. 5.
The rates of brain metastases according to the presence of other established synchronous metastatic sites.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Siegel R, Ward E, Brawley O, et al. Cancer statistics, 2011: The impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011;61:212–36. doi: 10.3322/caac.20121. - DOI - PubMed
    1. Sonpavde G, Sternberg CN, Rosenberg JE, et al. Second-line systemic therapy and emerging drugs for metastatic transitional-cell carcinoma of the urothelium. Lancet Oncol. 2010;11:861–70. doi: 10.1016/S1470-2045(10)70086-3. - DOI - PubMed
    1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11–30. doi: 10.3322/caac.21166. - DOI - PubMed
    1. Bharat A, Aft RL, Gao F, et al. Patient and tumor characteristics associated with increased mortality in young women (≤40 years) with breast cancer. J Surg Oncol. 2009;100:248–51. doi: 10.1002/jso.21268. - DOI - PubMed
    1. Derwinger K, Kodeda K, Gerjy R. Age aspects of demography, pathology and survival assessment in colorectal cancer. Anticancer Res. 2010;30:5227–31. - PubMed

LinkOut - more resources