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Purpose <p>To compare survival outcomes between patients with urothelial carcinoma of the prostate (UPC) and adenocarcinoma of the prostate (APC) and to explore the prognostic factors of UPC.</p> Methods <p>Data from prostate cancer patients diagnosed between 2004 and 2019 were extracted from the SEER database. This study included 800,896 APC cases and 95 UPC cases. Propensity score matching (PSM) at a ratio of 1:1 was used to generate comparable cohorts. Multivariable Cox models determined the risks of cancer-specific mortality (CSM) and overall mortality (OM) for UPC compared to APC. Lastly, univariate and multivariate COX regression analyses identified independent risk and protective factors for CSM and OM in UPC patients.</p> Results <p>UPC patients were older at diagnosis (median age 75 vs. 66 y, p &lt; 0.001) and had more regional or distant tumor stages (32.6% vs. 17.6%, p &lt; 0.001) compared to APC patients. Though receiving more surgery (61.1% vs. 38.5%, p &lt; 0.001), radiotherapy (7.4% vs. 3.1%, p &lt; 0.05), and systemic treatment recorded (11.6% vs. 3.3%, p &lt; 0.001), UPC patients showed significantly shorter median survival (21&#xa0;m vs. 75&#xa0;m, p &lt; 0.001), along with higher risks of CSM (HR 5.58, 95% CI 2.59–11.99, p &lt; 0.001) and OM (HR 3.73, 95% CI 2.34–5.95, p &lt; 0.001) after PSM. Subgroup analysis of UPC revealed that advanced stage was an independent risk factor for CSM (p &lt; 0.001). Older age and advanced stage raised OM risk (p &lt; 0.001), while systemic treatment recorded was associated with reduced CSM and OM risks (p &lt; 0.05).</p> Conclusion <p>Our study highlighted the poorer prognosis of UPC compared to APC, with significant higher CSM and OM. Advanced stage increased CSM risk, while older age and advanced stage increased OM risk. Systemic treatment recorded was associated with improved outcomes on CSM and OM, emphasizing the importance of advancements in diagnosis and treatment for improving UPC prognosis.</p>

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Survival and prognostic factors in rare urothelial carcinoma of the prostate compared to adenocarcinoma of the prostate: a propensity score matched analysis based on the SEER database

  • 期刊论文

  • 发表日期：

    2025年12月27日

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  • Ruochen Zhang,
  • Yiming Jin,
  • Deng Lin,
  • Jun Lu,
  • Le Lin,
  • Liefu Ye,
  • Tao Li,
  • Hisamitsu Ide,
  • Shigeo Horie,
  • Wei Song,
  • Yan Lu,
  • Yongbao Wei

摘要

Purpose

To compare survival outcomes between patients with urothelial carcinoma of the prostate (UPC) and adenocarcinoma of the prostate (APC) and to explore the prognostic factors of UPC.

Methods

Data from prostate cancer patients diagnosed between 2004 and 2019 were extracted from the SEER database. This study included 800,896 APC cases and 95 UPC cases. Propensity score matching (PSM) at a ratio of 1:1 was used to generate comparable cohorts. Multivariable Cox models determined the risks of cancer-specific mortality (CSM) and overall mortality (OM) for UPC compared to APC. Lastly, univariate and multivariate COX regression analyses identified independent risk and protective factors for CSM and OM in UPC patients.

Results

UPC patients were older at diagnosis (median age 75 vs. 66 y, p < 0.001) and had more regional or distant tumor stages (32.6% vs. 17.6%, p < 0.001) compared to APC patients. Though receiving more surgery (61.1% vs. 38.5%, p < 0.001), radiotherapy (7.4% vs. 3.1%, p < 0.05), and systemic treatment recorded (11.6% vs. 3.3%, p < 0.001), UPC patients showed significantly shorter median survival (21 m vs. 75 m, p < 0.001), along with higher risks of CSM (HR 5.58, 95% CI 2.59–11.99, p < 0.001) and OM (HR 3.73, 95% CI 2.34–5.95, p < 0.001) after PSM. Subgroup analysis of UPC revealed that advanced stage was an independent risk factor for CSM (p < 0.001). Older age and advanced stage raised OM risk (p < 0.001), while systemic treatment recorded was associated with reduced CSM and OM risks (p < 0.05).

Conclusion

Our study highlighted the poorer prognosis of UPC compared to APC, with significant higher CSM and OM. Advanced stage increased CSM risk, while older age and advanced stage increased OM risk. Systemic treatment recorded was associated with improved outcomes on CSM and OM, emphasizing the importance of advancements in diagnosis and treatment for improving UPC prognosis.