劉家翔¹、黃逸修^{1, 2}、鍾孝仁^{1, 2}、林子平^{1, 2}、張延驊^{1, 2}、陳光國^{1, 2}、盧星華^{1, 2}、郭俊逸^{1, 2}、

黃志賢^{1, 2}

臺北榮民總醫院泌尿部¹國立陽明大學醫學系泌尿學科²書田泌尿科學研究中心³

Chia-Hsiang Liu¹, Eric Y.H. Huang^1,2, Hsiao-Jen Chung ^1,2, Tzu-Ping Lin ^1,2, Yen-Hwa Chang ^1,2, Kuang-Kuo Chen ^1,2, Shing-Hwa Lu ^1,2, Junne-Yih Kuo ^1,2,Williams J.S. Huang ^1,2

¹ Department of Urology, Taipei Veterans General Hospital,

² Department of Urology, School of Medicine and Shu-Tien Urological Science Research Center,
National Yang-Ming University, Taipei, Taiwan

 

Less than 10% of bladder cancer are non-urothelial histologic variant, which is associated with worse outcomes. Adenocarcinoma of the bladder is a very rare entity which accounts for only 1% of urinary bladder carcinomas. It may arise primarily in the bladder as well as secondarily from a number of other organs. The aim of this study is to investigate the treatment patterns and outcomes of primary adenocarcinoma of urinary bladder in a single insititute.

 

A retrospective review was conducted to identify all patients with primary adenocarcinoma of urinary bladder treated at our hospital from 2000 through 2018. The characteristics of the patients, treatment patterns, and oncological outcomes were reviewed.

 

A total of 14 patients, including 6 women and 8 men, were identified with primary adenocarcinoma of urinary bladder. The mean age was 63.1 years (range 42-95 years). The tumor stage was 9 with T1, 3 with T2, and 2 with T3. Among them, 5 patients (36%) received cystectomy (1 partial cystectomy in T2, 4 radical cystectomy in T1(n=2)/T3(n=2) and 9 had transurethral resection in T1(n=7)/T2(n=2). Mean follow-up time was 47.3 (4-175) months with 5-year overall survival rate of 65%. Three patients died of cancer with a mean survival time of 14.3 months (range, 5-22 months). Cancer specific survival was 56.3 months (range 4-175 months). There was one cancer-specific death for each T stage with the survival time of 22 months for T1, 5 months for T2, and 16 months for T3 disease.. No metastasis or recurrence was noted for the 5 patients who received cystectomy but 2 patients developed metastases among the 9 patients who received transurethral resection. The common sites of metastases included the lung (n=2) and brain (n=1).

 

Primary adenocarcinoma of urinary bladder is a rare malignancy and has variable outcomes. Radical cystectomy may offer better oncological outcomes compared to conservative management.