Clinicopathological characteristics and treatment outcomes of 162 Chinese patients with metastatic bladder cancer: results from a tertiary teaching hospital

BACKGROUND: To explore the relationship between clinicopathological features and prognosis of metastatic bladder cancer (MBC) patients in the real world, and to provide peculiar data support for the management of such patients. METHODS: A retrospective analysis of 162 MBC patients who underwent radical cystectomy (RC) in West China Hospital, Sichuan University from September 2010 to December 2015 was conducted. The study included the clinical, pathological and metastatic features of these patients. Chi-square test, Kaplan-Meier method and Cox proportional hazard model were used to assess the relationship between clinicopathological factors and outcomes. RESULTS: Of the 162 patients enrolled, 137 (84.6%) were male and 25 (15.4%) were female. The ages at which the tumors metastasize for men and women were 64.8±9.4 and 66.2±12.7 years, respectively (P=0.52). The median follow-up time was 13.6 months (IQR: 5.8–33.1 months). Smoking history, pathological stages, and marginal status were independent predictors of the metastasis-free interval (MFI); Pathological stages, local recurrence, liver metastasis, and surgical approaches were significantly associated with cancer-specific survival (CSS) and overall survival (OS). Besides, OS was associated with lymphovascular invasion (LVI) and age at metastasis. CONCLUSIONS: Our study suggests that tumors in MBC patients with a smoking history, positive margins, pT3 or more advanced tumors are more likely to metastasize. Besides, patients with a minimally invasive surgery, local recurrence, and liver metastases are at greater risk of death from bladder cancer; Taken together, our study provides data support for an optimal management of patients with MBC in current real-world practice.