Discussion
papillary tumor, tumor, comorbidity, micropapillary breast cancer, cancer, urothelial carcinoma, micropapillary bladder cancer, bladder cancer, muscle-invasive bladder cancer, tumors, Micropapillary bladder cancer, AJCC
TUMOR, MICROPAPILLARY CARCINOMA, CANCER, UROTHELIAL CARCINOMA, BLADDER CANCER, INFILTRATING, TUMORS, METASTASES
Micropapillary carcinoma, a rare variant, is composed of infiltrating slender delicate filiform processes or small tight papillary tumor cell clusters that lie within lacunae [Although AJCC TNM staging system is popular for cancer prognosis, the rationality of its application in micropapillary bladder cancer has been much debated. Firstly, the TNM staging system is established mainly based on conventional urothelial carcinoma instead of micropapillary bladder cancer. Micropapillary bladder cancer has been reported to have a poorer prognosis than conventional bladder cancer, but a recent study showed that clinical outcomes were comparable to conventional bladder cancer after controlling for standard clinicopathologic predictors [Our study identified six independent prognostic factors for CSS, including age, marital status, AJCC stage, tumor size, surgery approach and positive lymph node ratio.Generally, older patients with decreased immunity and increased numbers of comorbidities are more likely to have poorer survival outcomes. Although age has not been reported to affect the prognosis of micropapillary bladder cancer, its effect on conventional bladder cancer and micropapillary breast cancer has been widely concerned [Marital status was used as a predictor of survival for various tumors, including bladder cancer [Similar to other tumors, clinicopathological features are also important prognostic indicators of micropapillary bladder cancer. Z Li et al. reported that micropapillary bladder cancer often presented at an advanced stage with lymphovascular invasion and distant metastases, and the prognosis was poor [In terms of surgical treatment, radical cystectomy is considered as the gold standard for muscle-invasive bladder cancer and refractory non-muscle-invasive bladder cancer. The optimal treatment of patients with cT1 remains controversial [However, there were several limitations in our study. First, this study was a retrospective analysis with inherent biases. Further efforts are needed to collect prospective data. Second, some important information is unavailable in the SEER database, such as blood test information, smoking history. Comorbidities information is also an important prognostic indicator, which can affect treatment choices and survival. Lack of comorbidity information is one of the limitations of this paper. Furthermore, although the C-indices of the two nomograms were greater than 0.7, indicating high accuracy in CSS and OS, about 30% of our predictions were wrong and nomograms need to be further improved.
