Secondary Neoplasms of the Urinary Bladder-Clinical Management and Oncological Outcomes
Background: Secondary neoplasms of the bladder account for 4.5% of all bladder neoplasms however there is limited literature reporting management and survival. This is the largest single centre series presented in current literature with long term oncological follow up. Methods: This is a single institutional, retrospective cohort study of patients with a histological diagnosis of a secondary bladder neoplasm from January 2007- December 2017 (n=40). Prognostic variables examined included age at diagnosis, histology, disease free survival and treatment. Kaplan-Meier analysis was used to calculate survival. We used multiple regression analysis to identify the most significant treatments for each population group in terms of their survival. Results: 21 patients were male [53%] with a median age of 68 and 19 were female [47%] with a median age of 64. The most common secondary neoplasms and their median survival were prostate (12 patients [30%], 446 days), colorectal (9 patients [23%], 403 days), ovarian (5 patients [13%], 369 days), cervical (4 patients [10%], 148 days), breast (3 patients [8%], 241 days) lymphoma (3 patients [8%], 145 days), Gastric (2 patients [5%], 66 days), and renal (2 patients [5%], 854 days). Those receiving treatment following a secondary diagnosis demonstrated statistical significance in survival for colorectal (surgery p=0.013), prostate (radiotherapy p=0.0012 and hormonal therapy p=0.004) and ovarian cancer (chemotherapy p=0.00002). Conclusion: Prognosis and treatment depends upon the primary neoplasm. There is some survival benefit in well selected patients receiving treatment following a diagnosis of a bladder secondary.