Squamous Cell Carcinoma of the Bladder: A SEER Database Analysis
Scarce evidence exists regarding the management of squamous cell carcinoma (SCC) of the bladder. Cases with SCC of the bladder, diagnosed from 1973 to 2013 were identified from the SEER database. For nonmetastatic SCC of the bladder, radical surgery achieves better outcomes compared with radiation therapy.Background:
Scarce evidence exists regarding the management of squamous cell carcinoma (SCC) of the bladder. This study assessed the epidemiologic and treatment trends of SCC of the bladder.Materials and Methods:
Cases of SCC of the bladder, diagnosed from 1973 to 2013, were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The incidence of SCC of the bladder with respect to time was assessed using the SEER United States population dataset. Relevant baseline characteristics were reported whenever available. Propensity-score matching for nonmetastatic patients receiving or not receiving radical surgery was then performed considering baseline characteristics. Survival analysis in the post-matching cohort was then evaluated using Kaplan-Meier analyses.Results:
A total of 5018 patients were identified. The median age group was 70 to 75 years. The incidence of bladder SCC has decreased during the period from 1973 to 2013 (P < .05). For the post-matching cohort, there was a statistically significant difference in cancer-specific and overall survival favoring the radical surgery group compared with radiation therapy or no treatment group (P < .0001 for both endpoints). The overall survival benefit was consistent regardless of the SEER stage (localized or regional). In multivariate analysis of the matched population, radical surgery, less advanced SEER summary stage, and age less than 70 years were associated with a better overall survival.Conclusion:
This analysis suggests that for nonmetastatic SCC of the bladder, radical surgery achieves better outcomes compared with radiation therapy. Prospective trials to evaluate formal multimodality bladder-preserving protocols in this histologic subtype are needed.