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
. 2025 Dec 27.
doi: 10.1007/s11255-025-04978-1. Online ahead of print.

Survival and prognostic factors in rare urothelial carcinoma of the prostate compared to adenocarcinoma of the prostate: a propensity score matched analysis based on the SEER database

Ruochen Zhang #  1 , Yiming Jin #  2 , Deng Lin  1   3 , Jun Lu  2 , Le Lin  1 , Liefu Ye  1 , Tao Li  1 , Hisamitsu Ide  2 , Shigeo Horie  2 , Wei Song  4 , Yan Lu  5 , Yongbao Wei  6   7
Affiliations

Survival and prognostic factors in rare urothelial carcinoma of the prostate compared to adenocarcinoma of the prostate: a propensity score matched analysis based on the SEER database

Ruochen Zhang et al. Int Urol Nephrol. .

Abstract

Purpose: To compare survival outcomes between patients with urothelial carcinoma of the prostate (UPC) and adenocarcinoma of the prostate (APC) and to explore the prognostic factors of UPC.

Methods: Data from prostate cancer patients diagnosed between 2004 and 2019 were extracted from the SEER database. This study included 800,896 APC cases and 95 UPC cases. Propensity score matching (PSM) at a ratio of 1:1 was used to generate comparable cohorts. Multivariable Cox models determined the risks of cancer-specific mortality (CSM) and overall mortality (OM) for UPC compared to APC. Lastly, univariate and multivariate COX regression analyses identified independent risk and protective factors for CSM and OM in UPC patients.

Results: UPC patients were older at diagnosis (median age 75 vs. 66 y, p < 0.001) and had more regional or distant tumor stages (32.6% vs. 17.6%, p < 0.001) compared to APC patients. Though receiving more surgery (61.1% vs. 38.5%, p < 0.001), radiotherapy (7.4% vs. 3.1%, p < 0.05), and systemic treatment recorded (11.6% vs. 3.3%, p < 0.001), UPC patients showed significantly shorter median survival (21 m vs. 75 m, p < 0.001), along with higher risks of CSM (HR 5.58, 95% CI 2.59-11.99, p < 0.001) and OM (HR 3.73, 95% CI 2.34-5.95, p < 0.001) after PSM. Subgroup analysis of UPC revealed that advanced stage was an independent risk factor for CSM (p < 0.001). Older age and advanced stage raised OM risk (p < 0.001), while systemic treatment recorded was associated with reduced CSM and OM risks (p < 0.05).

Conclusion: Our study highlighted the poorer prognosis of UPC compared to APC, with significant higher CSM and OM. Advanced stage increased CSM risk, while older age and advanced stage increased OM risk. Systemic treatment recorded was associated with improved outcomes on CSM and OM, emphasizing the importance of advancements in diagnosis and treatment for improving UPC prognosis.

Keywords: Adenocarcinoma of the prostate; Cancer mortality; Propensity score matching; Prostate cancer; Risk factor; Urothelial carcinoma.

PubMed Disclaimer

Conflict of interest statement

Declarations: The authors declare no competing interests. Ethical approval and consent to participate: Not applicable. Informed consent: Not applicable. Patient consent for publication: Not applicable. Institutional review board statement: Not applicable.

References

    1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386 - DOI - PubMed
    1. Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE (2016) The 2016 WHO classification of tumours of the urinary system and male genital organs-Part B: prostate and bladder tumours. Eur Urol 70(1):106–119 - DOI - PubMed
    1. Ende N, Woods LP, Shelley HS (1963) Carcinoma originating in ducts surrounding the prostatic urethra. Am J Clin Pathol 40:183–189 - DOI - PubMed
    1. Kirk D, Hinton CE, Shaldon C (1979) Transitional cell carcinoma of the prostate. Br J Urol 51(6):575–578 - DOI - PubMed
    1. Rubenstein AB, Rubnitz ME (1969) Transitional cell carcinoma of the prostate. Cancer 24(3):543–546 - DOI - PubMed

LinkOut - more resources