Current status of diagnosis and treatment of bladder cancer in China - Analyses of Chinese Bladder Cancer Consortium database.

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.

RESULTS:

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.

• Authors: Kaiwen Li, Tianxin Lin, Chinese Bladder Cancer Consortium, Wei Xue, Xin Mu, Enci Xu, Xu Yang, Fubao Chen, Guangyong Li, Lulin Ma, Guoliang Wang, Chaozhao Liang, Haoqiang Shi, Ming Li, Mao Tang, Xueyi Xue, Yisong Lv, Yaoliang Deng, Chengyang Li, Zhiwen Chen, Xiaozhou Zhou, Fengshuo Jin, Xudong Liu, Jinxin Wei, Lei Shi, Xin Gou, Weiyang He, Liqun Zhou, Lin Cai, Baiye Jin, Guanghou Fu, Xiangbo Kong, Hongyan Sun, Ye Tian, Lang Feng, Tiejun Pan, Yiyi Wu, Dongwen Wang, Hailong Hao, Benkang Shi, Yaofeng Zhu, Qiang Wei, Ping Han, Changli Wu, Dawei Tian, Zhangqun Ye, Zheng Liu, Zhiping Wang, Junqiang Tian, Lin Qi, Minfeng Chen, Wei Li, Jinchun Qi, Gongxian Wang, Longlong Fu, Zhaolin Sun, Guangheng Luo, Zhoujun Shen, Zhaowei Zhu, Jinchun Xing, Zhun Wu, Dong Wei, Xin Chen, Yanqun Na, Hongfeng Guo, Chunxi Wang, Zhihua Lu, Chuize Kong, Yang Liu, Jin Yang, Jianyun Hu, Xin Gao, Jielin Li, Changjun Yin, Pu Li, Shan Chen, Zhen Du, Jiongming Li, Yongji Yan, Xu Zhang, Shuang Huang, Fangjian Zhou, Zhiling Zhang, Yinghao Sun, Shuxiong Zeng, Song Cen, Jiaquan Zhou, Hanzhong Li, Jin Wen, Jian Huang
• Journal: Asian journal of urology (Asian J Urol) Vol. 2 Issue 2 Pg. 63-69 (Apr 2015) ISSN: 2214-3882 [Print] Singapore
• PMID: 29264122 (Publication Type: Journal Article)