1. Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University Guangzhou, China;
2. Department of Urology, Renji Hospital,Shanghai Jiaotong University School of Medicine, Shanghai, China;
3. Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China;
4. Department of Urology, General Hospital of Ningxia Medical University, Yinchuan, China;
5. Department of Urology, Peking University Third Hospital, Beijing, China;
6. Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China;
7. Department of Urology, The Xinjiang Uygur Autonomous Region people's Hospital, Uygur, China;
8. Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China;
9. Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China;
10. Department of Urology, Southwest Hospital, Third Military Medical University, Chongqing, China;
11. Department of Urology, Daping Hospital, Third Military Medical University, Chongqing, China;
12. Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China;
13. Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China;
14. Department of Urology, Peking University First Hospital, Beijing, China;
15. Department of Urology, The First Affiliated Hospital of Zhejiang University, Hangzhou, China;
16. Department of Urology, China Japan Friendship Hospital of Jilin University, Changchun, China;
17. Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China;
18. Department of Urology, Wuhan General Hospital of Guangzhou Military, Wuhan, China;
19. Department of Urology, The First Affiliated Hospital of Shanxi University, Taiyuan, China;
20. Department of Urology, Qilu Hospital of Shandong University, Jinan, China;
21. Department of Urology, West China Hospital, Sichuan University, Chengdu, China;
22. Department of Urology, The Second Affiliated Hospital of Tianjin Medical University, Tianjin, China;
23. Department of Urology, Tongji Medical College Huazhong University of Science and Technology, Wuhan, China;
24. Department of Urology, Lanzhou University Second Hospital, Lanzhou, China;
25. Department of Urology, Xiangya Hospital Central South University, Changsha, China;
26. Department of Urology, The Second Hospital of Hebei Medical University, Shijiazhuang, China;
27. Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China;
28. Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China;
29. Department of Urology, Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China;
30. Department of Urology, The First Affiliated Hospital of Xiamen University, Xiamen, China;
31. Department of Urology, Beijing Hospital, Beijing, China;
32. Department of Urology, Peking University, Wu Jieping Urology Center, Beijing, China;
33. Department of Urology, The First Hospital of Jilin University, Changchun, China;
34. Department of Urology, The First Hospital of China Medical University, Shenyang, China;
35. Department of Urology, Affiliated Hospital of Chengdu University, Chengdu, China;
36. Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China;
37. Department of Urology, Jiangsu Province Hospital, Nanjing, China;
38. Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, China;
39. Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China;
40. Department of Urology, Chinese PLA General Hospital, Beijing, China;
41. Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China;
42. Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China;
43. Department of Urology, Hainan General Hospital, Haikou, China;
44. Department of Urology, Peking Union Medical College Hospital, Beijing, China
Abstract: Objective: To investigate current status of diagnosis and treatment of bladder cancer in China. Methods: A database was generated by Chinese Bladder Cancer Consortium (CBCC). From January 2007 to December 2012, 14,260 cases from 44 CBCC centers were included. Data of diagnosis, treatment and pathology were collected. Resultsa: The average age was 63.5 year-old and most patients were male (84.3%). The most common histologic types were urothelial carcinoma (91.4%), adenocarcinoma (1.8%), and squamous carcinoma (1.9%). According to 1973 and 2004 WHO grading system, 42.0%, 41.0%, and 17.0% of patients were grade 1, 2, and 3, and 16.0%, 48.7%, and 35.3% of patients were papillary urothelial neoplasms of low malignant potential, low, and high grade, respectively. Non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC) were 25.2% and 74.1%, respectively (0.8% not clear). Carcinoma in situ was only 2.4%. Most patients were diagnosed by white-light cystoscopy with biopsy (74.3%). Fluorescence and narrow band imaging cystoscopy had additional detection rate of 1.0% and 4.0%, respectively. Diagnostic transurethral resection (TUR) provided detection rate of 16.9%. Most NMIBCs were treated with TUR (89.2%). After initial TUR, 2.6% accepted second TUR, and 45.7%, 69.9%, and 58.7% accepted immediate, induced, and maintenance chemotherapy instillation, respectively. Most MIBCs were treated with radical cystectomy (RC, 59.7%). Laparoscopic RCs were 35.1%, while open RC 63.4%. Extended and standard pelvic lymph node dissection were 7% and 66%, respectively. Three most common urinary diversions were orthotopic neobladder (44%), ileal conduit (31%), and ureterocutaneostomy (23%). Only 2.3% of patients accepted neo-adjuvant chemotherapy and only 18% of T3 and T4 patients accepted adjuvant chemotherapy. Conclusion: Disease characteristics are similar to international reports, while differences of diagnosis and treatment exist. This study can provide evidences for revisions of the guideline on bladder cancer in China.
Siwei Z, Jianhui M, Ming L, Yanqun N, Wanqing C. Incidence trends of bladder cancer in cities and counties in China. Chin J Urol 2009;10:673-6.
[2]
Sujun H, Siwei Z, Wanqing C, Changling L. Analysis of the status quo and trends: mortality in patients with bladder cancer in China. J Modern Urol 2013;18:228-32.
[3]
Jian H, Chaozhao L, Liqun Z, Wei X, Dong W, Fangjian Z, et al. Giudelines of diagnosis and treatment on bladder cancer. In: Yanqun N, Zhangqun Y, Yinghao S, Guang S, Jian H, Chuize K, et al., editors. Guidelines on urology in China. 2014 ed. Beijing: People's Medical Publishing House; 2014. p. 20-60.
[4]
Kamat AM, Hegarty PK, Gee JR, Clark PE, Svatek RS, Hegarty N, et al. ICUD-EAU International Consultation on Bladder Cancer 2012: Screening, diagnosis, and molecular markers. Eur Urol 2013;63:4-15.
[5]
Kausch I, Sommerauer M, Montorsi F, Stenzl A, Jacqmin D, Jichlinski P, et al. Photodynamic diagnosis in non-muscle-invasive bladder cancer: a systematic review and cumulative analysis of prospective studies. Eur Urol 2010;57:595-606.
[6]
He Y, Zha J, Wang Y, Liu W, Yang X, Yu P. Tissue damageassociated 'danger signals' influence T-cell responses that promote the progression of preneoplasia to cancer. Cancer Res 2013;73:629-39.
[7]
Brausi M, Collette L, Kurth K, van der Meijden AP, Oosterlinck W, Witjes JA, et al. Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol 2002;41:523-31.
[8]
Datta SN, Allen GM, Evans R, Vaughton KC, Lucas MG. Urinary tract ultrasonography in the evaluation of haematuria--a report of over 1,000 cases. Ann R Coll Surg Engl 2002;84:203-5.
[9]
Lotan Y, Roehrborn CG. Sensitivity and specificity of commonly available bladder tumor markers versus cytology: results of a comprehensive literature review and meta-analyses. Urology 2003;61:109-18.
[10]
Tilki D, Burger M, Dalbagni G, Grossman HB, Hakenberg OW, Palou J, et al. Urine markers for detection and surveillance of nonmuscle-invasive bladder cancer. Eur Urol 2011;60:484-92.
[11]
Fleshner NE, Herr HW, Stewart AK, Murphy GP, Mettlin C, Menck HR. The National Cancer Data Base report on bladder carcinoma. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer 1996;78:1505-13.
[12]
Kantor AF, Hartge P, Hoover RN, Fraumeni JF Jr. Epidemiological characteristics of squamous cell carcinoma and adenocarcinoma of the bladder. Cancer Res 1988;48:3853-5.
[13]
Gontero P, Sylvester R, Pisano F, Joniau S, Vander Eeckt K, Serretta V, et al. Prognostic factors and risk groups in T1G3 non-muscleinvasive bladder cancer patients initially treated with bacillus calmette-guerin: results of a retrospective multicenter study of 2451 patients. Eur Urol 2014;16:614-9.
[14]
Divrik RT, Yildirim U, Zorlu F, Ozen H. The effect of repeat transurethral resection on recurrence and progression rates in patients with T1 tumors of the bladder who received intravesical mitomycin: a prospective, randomized clinical trial. J Urol 2006;175:1641-4.
[15]
Holmang S. High-grade non-muscle-invasive bladder cancer: is re-resection necessary in all patients before intravesical bacillus Calmette-Guerin treatment? Scand J Urol 2013;47:363-9.
[16]
Angulo JC, Palou J, Garcia-Tello A, de Fata FR, Rodriguez O, Villavicencio H. Second transurethral resection and prognosis of high-grade non-muscle invasive bladder cancer in patients not receiving bacillus Calmette-Guerin. Actas Urol Esp 2014;38:164-71.
[17]
Lazica DA, Roth S, Brandt AS, Bottcher S, Mathers MJ, Ubrig B. Second transurethral resection after Ta high-grade bladder tumor: a 4.5-year period at a single university center. Urol Int 2014;92:131-5.
[18]
Linder BJ, Frank I, Cheville JC, Tollefson MK, Thompson RH, Tarrell RF, et al. The impact of perioperative blood transfusion on cancer recurrence and survival following radical cystectomy. Eur Urol 2013;63:839-45.
[19]
Hautmann RE, Abol-Enein H, Davidsson T, Gudjonsson S, Hautmann SH, Holm HV, et al. ICUD-EAU International Consultation on Bladder Cancer 2012: Urinary diversion. Eur Urol 2013;63:67-80.
[20]
Kassouf W, Swanson D, Kamat AM, Leibovici D, Siefker-Radtke A, Munsell MF, et al. Partial cystectomy for muscle invasive urothelial carcinoma of the bladder: a contemporary review of the M. D. Anderson Cancer Center experience. J Urol 2006;175:2058-62.
[21]
Sweeney P, Kursh ED, Resnick MI. Partial cystectomy. Urol Clin North Am 1992;19:701-11.
[22]
Ma B, Li H, Zhang C, Yang K, Qiao B, Zhang Z, et al. Lymphovascular invasion, ureteral reimplantation and prior history of urothelial carcinoma are associated with poor prognosis after partial cystectomy for muscle-invasive bladder cancer with negative pelvic lymph nodes. Eur J Surg Oncol 2013;39:1150-6.
Christopher Hartman, Nikhil Gupta, David Leavitt, David Hoenig, Zeph Okeke, Arthur Smith. Advances in percutaneous stone surgery[J]. Asian Journal of Urology, 2015, 2(1): 26
-32
.
