Urothelial carcinoma versus squamous cell carcinoma of bladder: is survival different with stage adjustment?
OBJECTIVE
To determine whether the survival of patients with squamous cell carcinoma (SCC) is different from that of patients with urothelial carcinoma, after adjusting for stage, grade, demographic factors, and the initial treatment.


METHODS
Information on bladder cancer cases diagnosed from 1988 to 2003 was obtained from the Surveillance, Epidemiology, and End Results database. The tumors were classified by histologic type, grade, and American Joint Committee on Cancer (AJCC) stage. Other covariates included age, sex, race, and information on the initial treatment (cystectomy and radiotherapy). The outcome variables examined were all-cause and bladder cancer-specific mortality within 2 years of diagnosis. Covariate-adjusted mortality differences were computed within each stage using the modified least squares model.


RESULTS
SCC histologic features were an independent predictor of all-cause and bladder cancer-specific mortality among patients with AJCC Stage I and II tumors who did not undergo cystectomy as a part of their initial treatment and among patients with AJCC Stage III and IV regardless of whether cystectomy was performed. SCC histologic features were not associated with increased mortality among patients with AJCC Stage I and II tumors treated with cystectomy.


CONCLUSIONS
SCC appears to be more aggressive than urothelial carcinoma after adjusting for stage and other prognostic factors, except for cases in which the tumor was confined to the bladder wall and the bladder was removed as a part of the initial treatment.
Scosyrev
Emil
E
Department of Community and Preventive Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA.
Yao
Jorge
J
Messing
Edward
E
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology*