Clinical Features of Sarcomatoid Carcinoma (Carcinosarcoma) of the Urinary Bladder: Analysis of 221 Cases

Abstract

Background. Urinary bladder sarcomatoid carcinoma (carcinosarcoma) is rare. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of urinary bladder carcinosarcoma using population-based registry. Methods. The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined. Results. A total of 221 histology confirmed cases were identified between 1973 and 2004, this accounted for approximately 0.11% of all primary bladder tumors during the study period. Median age of the patients was 75 years (range 41–96). Of the patients with a known tumor stage (N = 204), 72.5% had a regional or distant stage; 98.4% of patients with known histology grade (N = 127), had poorly or undifferentiated histology. Multiple primary tumors were indentified in about 40% of study subjects. The majority of patients (95.9%) received cancer directed surgery, 35.8% had radical or partial cystectomy, 15.8% of patients received radiation therapy combination with surgery. The median overall survival was 14 months (95% CI 7–21 months). 1-, 5-, and 10-year cancer specific survival rate were 53.9%, 28.4% and 25.8%. In a multivariate analysis, only tumor stage was found to be a significant prognostic factor for disease-specific survival. Conclusions. Urinary bladder carcinosarcoma commonly presented as high grade, advanced stage and aggressive behavior with a poor prognosis. Emphasis on early detection, including identification of risk factors is needed to improve the outcome for patients with this malignancy.

A Report of Spindle Cell Carcinoma in Maxillary Sinus: Diagnosis and Management

“…Most sarcomatoid carcinomas in hollow viscus are polypoid and pedunculated (6,7). The occurrence of this tumor in nasal cavity and paranasal sinus is rare (8), with only 15 cases reported in the English literature (4,8,9).…”

Carcinosarcoma of the upper urinary tract with an aggressive angiosarcoma component

“…From 1988 to 2003, only 0.09% of high grade bladder cancers were CS, and the age-adjusted incidence was 2 per 10,000,000 persons per year. 9 CS in the bladder occurs more often in elderly men and is a highly malignant tumor, with a greater risk of death than urothelial carcinoma. 10 CS of the upper urinary tract is even rarer, with only 12 cases reported until 2006, 11 compared to 14 cases of CS of the renal pelvis.…”

Early Detection and Gemcitabine/Cisplatin Combination Positively Effect Survival in Sarcomatoid Carcinoma of the Urinary Bladder

“…The diagnosis of sarcomatoid carcinoma must be considered in all adult patients with malignant spindle cell tumor of the bladder, unless proven otherwise. The recognition of sarcomatoid carcinomas has great therapeutic and prognostic significance (Wang et al, 2010).…”

“…Although the combination of gemcitabine and cisplatin is a well-tolerated combination in advancedstage urothelial carcinoma patients, the literature contains few cases regarding its use in carcinosarcoma. Some researchers reported that they obtained good results with ovarian-or sarcoma-type chemotherapy regimens (Wang et al, 2010). We used a systemically administered combination of gemcitabine and cisplatin regimen in the presented cases.…”