Differences in prognosis between patients with metastatic urothelial carcinoma of different primary sites before and after the approval of ICIs:a cohort study based on the SEER database
10.3969/j.issn.1009-8291.2025.10.004
- VernacularTitle:免疫检查点抑制剂获批前后不同原发部位转移性尿路上皮癌患者预后的差异:基于SEER数据库的队列研究
- Author:
Fei WANG
1
;
Jiankang XU
;
Yadong GE
;
Qingfeng MENG
;
Feng HE
;
Jianpo ZHAI
Author Information
1. 首都医科大学附属北京积水潭医院泌尿外科,北京 100035
- Publication Type:Journal Article
- Keywords:
bladder cancer;
metastatic urothelial carcinoma;
immunotherapy;
immune checkpoints inhibitors;
primary site of tumor
- From:
Journal of Modern Urology
2025;30(10):833-841
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the impact of different primary tumor sites on the survival of patients with metastatic urothelial carcinoma(mUC)before and after the approval of immune checkpoints inhibitors(ICIs)based on data from Surveillance,Epidemiology,and End Results(SEER).Methods The mUC cases during 2013 and 2017 in the SEER database were enrolled.Cohorts were defined by primary tumor sites(renal pelvis,ureter,bladder)and then stratified by ICIs availability into non-ICIs era(2013)and ICIs era(2017).The survival differences in each cohort between the two eras were compared,and stratified analysis was performed.The 2-year overall survival(OS)was assessed using Kaplan-Meier analysis and multivariable Cox proportional hazards analysis.Results A total of 1750 mUC cases were enrolled,with 785 cases in the non-ICIs era and 965 in the ICIs era.No significant differences existed across different anatomical sites in the non-ICIs era,whether in the whole urinary system or inside bladder.The 2-year survival rates were 23.5％for ureteral cancer,18.0％for renal pelvic cancer,and 15.9％for bladder cancer.Significant prognostic disparities emerged among patients based on primary tumor sites in ICIs era(P＜0.05).The 2-year survival rates were 37.7％for ureteral cancer,25.5％for renal pelvic cancer,and 25.7％for bladder cancer.Further analysis revealed that the OS of the lesions originating from the bladder dome was significantly longer than that of the other bladder subgroups(P＜0.05),while the OS of the lesions in bladder bottom was the shortest.The 2-year survival rates were 52.0％for the bladder dome,13.0％for the bladder body,and 10.7％for the bladder bottom.Conclusion Our study indicates that in the non-ICIs era,there was no significant difference in the prognosis among mUC patients with lesions from different primary sites.In the ICIs era,the OS of ureteral cancer was significantly longer than that of bladder cancer and renal pelvis cancer.As for patients with metastatic bladder cancer,those with tumor located at the top of the bladder had a significantly better prognosis than those with tumors at other sites.
