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. 2022 Aug;11(8):2742-2756.
doi: 10.21037/tcr-22-46.

Incidence, prognostic factors and survival in bladder cancer patients: a population-based study

Shun-De Wang  1   2 , Cheng-Guo Ge  2 , Jun-Yong Zhang  2
Affiliations

Incidence, prognostic factors and survival in bladder cancer patients: a population-based study

Shun-De Wang et al. Transl Cancer Res. 2022 Aug.

Abstract

Background: The aim of this study was to investigate the incidence, epidemiologic characteristics, prognostic factors and survival of patients with bladder cancer.

Methods: Bladder cancer patients diagnosed between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox proportional hazards regression analyses were used to identify the independent prognostic factors for overall survival. Kaplan-Meier survival analysis and nomogram analysis were constructed based on the identified independent prognostic factors.

Results: A total of 95,329 eligible bladder cancer patients were included in this study. Eight independent risk factors, including age, histologic type, race, tumor, node and metastasis (TNM) stage, American Joint Committee on Cancer (AJCC) stage, surgery, tumor metastasis and summary stage, were recognized by using multivariate logistic regression models. By comprising these factors, a predictive nomogram was constructed to predict the 1-, 3-, and 5-year overall survival possibilities. The concordance index and calibration curve showed that the nomogram had robust and accurate performance.

Conclusions: Bladder cancer is the most common cancer of the urinary system, but the overall incidence has been decreasing yearly since 1992. Our results demonstrate eight factors significantly associated with overall survival in bladder cancer patients. Based on these factors, we established and validated a nomogram, which has the potential to provide an individualized prediction of overall survival in patients with bladder cancer.

Keywords: Bladder cancer (BC); Surveillance, Epidemiology, and End Results (SEER); multivariate; overall survival (OS).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tcr.amegroups.com/article/view/10.21037/tcr-22-46/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Annual age-adjusted incidence of bladder cancer decreased from 1992 to 2018 (A), and stratified by sex (B), race (C), age (D), and tumor stage (E).
Figure 2
Figure 2
Kaplan-Meier survival curves for overall patients with bladder cancer in different conditions: age (A), race (B), summary stage (C), AJCC stage (D), histologic type (E), surgery (F). API, Asian or Pacific Islander; AIAN, American Indian/Alaska Native; Tcc, transitional cell carcinoma; Scc, squamous cell carcinoma; Ac, adenocarcinoma; Nec, neuroendocrine carcinoma; Oet, other epithelial tumors; TURBT, transurethral resection of bladder tumor; PC, partial cystectomy; RC, radical cystectomy.
Figure 3
Figure 3
Kaplan-Meier survival curves for different histologic types in different surgeries of bladder cancer patients. Tcc, transitional cell carcinoma; Scc, squamous cell carcinoma; Ac, adenocarcinoma; Nec, neuroendocrine carcinoma; Oet, other epithelial tumors; TURBT, transurethral resection of bladder tumor; PC, partial cystectomy; RC, radical cystectomy.
Figure 4
Figure 4
Kaplan–Meier survival for different histologic types (A) and races (B) in bladder cancer patients by sex. API, Asian or Pacific Islander; AIAN, American Indian/Alaska Native; Tcc, transitional cell carcinoma; Scc, squamous cell carcinoma; Ac, adenocarcinoma; Nec, neuroendocrine carcinoma; Oet, other epithelial tumors.
Figure 5
Figure 5
Nomogram of prediction for 1-, 3- and 5-year overall survival of bladder cancer. API, Asian or Pacific Islander; AIAN, American Indian/Alaska Native; Tcc, Transitional cell carcinoma; Scc, squamous cell carcinoma; Ac, adenocarcinoma; Nec, neuroendocrine carcinoma; Oet, other epithelial tumors; TURBT, transurethral resection of bladder tumor; PC, partial cystectomy; RC, radical cystectomy.
Figure 6
Figure 6
Calibration curves of the nomogram-predicted 1- (A), 3- (B) and 5-year (C) overall survival.
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