Transitional cell carcinoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2] Anum Gull M.B.B.S.[3]
Overview
Common complications of transitional cell carcinoma include metastasis, anemia, hydronephrosis, urethral stricture, and urinary incontinence. Depending on the stage and grade of the tumor at the time of diagnosis, the prognosis of transitional cell carcinoma may vary. However, the 5-year survival rate of patients with bladder transitional cell carcinoma is approximately 77.5% and of patients with upper urinary tract transitional cell carcinoma is approximately 75%.
Natural History, Complications, and Prognosis
Complications
Common complications of transitional cell carcinoma include:
Prognosis
Transitional cell carcinoma of bladder
- Based on data from 2005-2011, the 5-year survival rate of patients with bladder cancer is approximately 77.4%.[1][2]
- Between 2004 and 2010, the 5-year relative survival of patients with bladder cancer was 79.1%.[3]
- When stratified by age, the 5-year relative survival of patients with bladder cancer was 83.8% and 74.1% for patients <65 and ≥ 65 years of age respectively.[3]
- The survival of patients with bladder cancer varies with the stage of the disease. Shown below is a table depicting the 5-year relative survival by the stage of bladder cancer:[3]
| Stage | 5-year relative survival (%), (2004-2010) |
| All stages | 77.4% |
| In situ | 96.2% |
| Localized | 69.2% |
| Regional | 33.7% |
| Distant | 5.5% |
| Unstaged | 48.7% |
- Shown below is an image depicting the 5-year conditional relative survival (probability of surviving in the next 5-years given the cohort has already survived 0, 1, 3 years) between 2004 and 2010 of bladder cancer by stage at diagnosis according to SEER. These graphs are adapted from SEER: The Surveillance, Epidemiology, and End Results Program of the National Cancer Institute.[3]
Transitional cell carcinoma of upper urinary tract
- Depending on the stage and grade of the tumor at the time of diagnosis, the prognosis may vary. However, the 5-year survival rate of patients with upper urinary tract transitional cell carcinoma is approximately 75%.[1]
- The major prognostic factor at the time of diagnosis of upper tract transitional cell cancer is the depth of infiltration into or through the uroepithelial wall.
- Most superficial tumors are likely to be well-differentiated, while infiltrative tumors are likely to be poorly differentiated.[4]
- They are curable in more than 90% of patients if they are superficial and confined to the renal pelvis or ureter.
- Patients with deeply invasive tumors that are still confined to the renal pelvis or ureter have a 10% to 15% likelihood of cure.
- Patients with tumors with penetration through the urothelial wall or with distant metastases usually cannot be cured with currently available forms of treatment.
- When involvement of the upper urinary tract is diffuse (involving both the renal pelvis and ureter), the likelihood of subsequent development of bladder cancer increases to 75%.
- DNA ploidy has not added significant prognostic information beyond that provided by stage and grade.
References
- ↑ 1.0 1.1 Munoz JJ, Ellison LM (2000). "Upper tract urothelial neoplasms: incidence and survival during the last 2 decades". J Urol. 164 (5): 1523–5. PMID 11025695.
- ↑ Bladder Cancer. Surveillance, Epidemiology, and End Results Program 2015.http://seer.cancer.gov/statfacts/html/urinb.html
- ↑ 3.0 3.1 3.2 3.3 Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2011/, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
- ↑ Transitional cell cancer. National cancer institute. http://www.cancer.gov/types/kidney/hp/transitional-cell-treatment-pdq#section/_1