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Patient-derived Orthotopic Xenograft Models for Human Urothelial Cell Carcinoma and Colorectal Cancer Tumor Growth and Spontaneous Metastasis
Published on: May 12, 2019
Pediatric urothelial cancer: a cross-sectional descriptive analysis of the National Cancer Database
Rafael Tua-Caraccia1, Leonid I Aksenov1, Rebecca J Fairchild1
1Department of Urology, Duke University School of Medicine, Durham, NC, USA.
Insights
Pediatric urothelial bladder cancer shows reassuring short-term survival. Most young patients with this rare cancer were alive at 90 days post-surgery, with no deaths reported after definitive treatment.
Area of Science:
- Pediatric oncology
- Urologic oncology
- Cancer epidemiology
Background:
- Urothelial cancer is a rare malignancy in children.
- Previous studies indicate lower recurrence and death rates in pediatric versus adult patients.
- This study investigates survival in pediatric urothelial bladder cancer.
Purpose of the Study:
- To analyze survival outcomes for pediatric urothelial bladder cancer.
- To compare survival rates in children and adolescents with adults.
- To assess the impact of tumor stage and treatment on survival.
Main Methods:
- Analysis of the National Cancer Database (NCDB) from 2004-2016.
- Inclusion of patients aged 0-18 years with urothelial bladder cancer (excluding rhabdomyosarcoma).
- Assessment of TNM staging, pathology, tumor size, surgical procedures, and survival data.
Main Results:
- 140 urothelial tumors were reported; 75.7% were stage 0 at diagnosis.
- No deaths occurred after definitive surgical resection among patients with available mortality data.
- Most patients (96.7%) were alive at 90 days, with only one reported mortality.
Conclusions:
- Short-term survival outcomes for pediatric urothelial bladder tumors are positive.
- Further research on long-term outcomes and surveillance is needed.
- This data supports the need for tailored management strategies for this rare cohort.
Background:
Urothelial cancer is a rare pediatric malignancy; previous analyses suggest lower rates of recurrence and death as compared to adults. We analyzed pediatric bladder cancer information in a national database, hypothesizing that survival would be better in children than adults.
Methods:
We analyzed the 2004-2016 National Cancer Database (NCDB) for children and adolescents (0-18 years) with urothelial bladder cancer. Rhabdomyosarcoma patients were excluded. Assessed variables included TNM staging, pathology, tumor size, surgical procedures, and post-operative re-admissions. Overall survival was defined as months since diagnosis as of last follow-up.
Results:
Of 140 urothelial tumors reported to NCDB between 2004-2016, 75.7% (N=106) were stage 0 at diagnosis, 6.4% (N=9) were stage I, 2.9% (N=4) were stage II and 3.6% (N=5) were stage IV, while 11.4% cases (N=16) were unknown. From available mortality data (121 patients), no patients died after definitive surgical resection. Only 1 mortality was reported at 90 days, although cause of death was reportedly unknown. Three (2.5%) patients were lost to follow-up, and most (96.7%) were alive at 90 days.
Conclusions:
Short-term survival outcomes among children and adolescents with urothelial bladder tumors captured in NCDB are reassuring. Future investigations focused on long-term outcomes and appropriate surveillance in this rare patient cohort are imperative to better guide management options.
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