Abstract

BACKGROUND:

The work-up and diagnosis of indeterminate lung nodules at time of bladder cancer diagnosis may delay or change treatment.

OBJECTIVE:

To quantify the incidence of synchronous and metachronous lung cancers in adults with bladder cancer and compare these rates to the incidence of bladder cancer metastases in the lung.

METHODS:

We retrospectively analyzed all adults diagnosed with bladder cancer in the Surveillance, Epidemiology and End Results (SEER) registry (2010– 2015) and identified second primary lung cancers defined as being either synchronous (diagnosed within 6 months of bladder cancer diagnosis) or metachronous (more than 6 months following index bladder cancer diagnosis). The risk of second primary lung cancers were reported as a standardized incidence ratio (SIR) reflecting observed and expected case ratios.

RESULTS:

A total of 88,335 patients diagnosed with bladder cancer were included. Among adults with NMIBC (n = 66,071) and MIBC (n = 18,879), 0.3% and 3.9% had bladder cancer metastatic to the lungs at diagnosis. Synchronous second primary lung cancers were diagnosed in 0.4% and 0.7% of patients with NMIBC and MIBC, respectively. Compared to the general population, the SIR for synchronous lung cancers among adults with NMIBC was 2.5 (95% CI 2.3– 2.9) and was 4.7 (95% CI 4.0– 5.6) for adults with MIBC.

CONCLUSIONS:

Bladder cancer metastatic to the lung is more common in adults with MIBC compared to NMIBC. There are similar frequencies of synchronous second primary lung cancers regardless of initial bladder cancer stage.

中文翻译：

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原发性膀胱尿路上皮癌患者的肺转移与第二原发肺癌：一项基于全国人群的评估

摘要

背景：

在膀胱癌诊断时对不确定肺结节的检查和诊断可能会延迟或改变治疗。

客观的：

量化成人膀胱癌同步和异时肺癌的发病率，并将这些发病率与膀胱癌肺部转移的发病率进行比较。

方法：

我们回顾性分析了在监测、流行病学和最终结果 (SEER) 登记处（2010-2015 年）中诊断为膀胱癌的所有成人，并确定了第二原发肺癌，定义为同步性（在膀胱癌诊断后 6 个月内诊断）或异时性（指标膀胱癌诊断后超过 6 个月）。第二原发肺癌的风险报告为标准化发病率 (SIR)，反映了观察到的和预期的病例比。

结果：

共纳入了 88,335 名诊断为膀胱癌的患者。在患有 NMIBC ( n  = 66,071) 和 MIBC ( n  = 18,879) 的成年人中，0.3% 和 3.9% 的膀胱癌在诊断时已转移至肺部。在 NMIBC 和 MIBC 患者中，分别有 0.4% 和 0.7% 的患者诊断出同步性第二原发肺癌。与一般人群相比，NMIBC 成人同步肺癌的 SIR 为 2.5（95% CI 2.3-2.9），MIBC 成人为 4.7（95% CI 4.0-5.6）。

结论：

与 NMIBC 相比，患有 MIBC 的成人中转移到肺的膀胱癌更常见。无论初始膀胱癌分期如何，同步第二原发肺癌的频率相似。