The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study

Abstract Objective To evaluate the effects of surgical interventions on individuals diagnosed with bladder neuroendocrine carcinoma (BNEC). Materials and methods Data were gathered from the Surveillance, Epidemiology, and End Results (SEER) database for this retrospective analysis. No-surgery proced...

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Main Authors: Jianyong Liu, Shicong Lai, Na Lu, Shuhang Luo, Runhua Tang, Lin Li, Pengjie Wu, Dongwen Wang, Jun Tian
Format: Article
Language:English
Published: BMC 2025-07-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02658-5
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author Jianyong Liu
Shicong Lai
Na Lu
Shuhang Luo
Runhua Tang
Lin Li
Pengjie Wu
Dongwen Wang
Jun Tian
author_facet Jianyong Liu
Shicong Lai
Na Lu
Shuhang Luo
Runhua Tang
Lin Li
Pengjie Wu
Dongwen Wang
Jun Tian
author_sort Jianyong Liu
collection DOAJ
description Abstract Objective To evaluate the effects of surgical interventions on individuals diagnosed with bladder neuroendocrine carcinoma (BNEC). Materials and methods Data were gathered from the Surveillance, Epidemiology, and End Results (SEER) database for this retrospective analysis. No-surgery procedures included TURBT, cryotherapy, excisional biopsy, or partial cystectomy. Surgery was categorized as cystectomy, radical cystectomy, or a more complex surgical intervention, such as exenteration. A propensity score overlap weight (PSOW) analysis was performed to adjust statistical influences between the two groups. Prognostic factors related to cancer-specific survival (CSS) and overall survival (OS) were assessed using Cox proportional hazard regression. Results A total of 2,442 participants were divided into two groups: no-surgery group (n = 1860) and surgery group (n = 582). Individuals in the no-surgery cohort showed a preference for radiation therapy (29.5% compared to 6.7%), whereas individuals in the surgery cohort were more prone to receiving chemotherapy (71.5% compared to 56.6%) as part of their treatment regimen. Surgery was determined to have a strong correlation with increased rates of OS (hazard ratio (HR) = 0.564, 95% confidence interval (CI) = 0.497–0.639, P < 0.001) and CSS (HR = 0.628, 95% CI 0.539–0.732, P < 0.001) results in BNEC patients. After PSOW, 307 patients were selected for each group. Surgical intervention demonstrated a notable enhancement in OS (P < 0.001) and CSS (P < 0.001) than those patients in the no-surgery group. Among the chemotherapy population, the median survival of patients in the surgery group was significantly higher when compared to those in the no-surgery group. Furthermore, individuals diagnosed with stage I (OS, HR = 0.202, 95% CI 0.112–0.366, P < 0.001; CSS HR = 0.198, 95% CI 0.083–0.472, P < 0.001) and II (OS HR = 0.417, 95% CI 0.331–0.525, P < 0.001; CSS HR = 0.415, 95% CI 0.307–0.561, P < 0.001) tumors who underwent surgical procedures exhibited improved long-term survival rates, whereas no surgical advantage was evident in later stages. Conclusions In the early stages of BNEC, individuals who undergo surgery experience improved survival rates. Therefore, it is important to carefully consider surgical treatment for patients with advanced BNEC.
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spelling doaj-art-5b3e3f4027a042af8673abfaf06673cd2025-08-20T04:01:25ZengBMCEuropean Journal of Medical Research2047-783X2025-07-0130111710.1186/s40001-025-02658-5The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort studyJianyong Liu0Shicong Lai1Na Lu2Shuhang Luo3Runhua Tang4Lin Li5Pengjie Wu6Dongwen Wang7Jun Tian8Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Urology, Peking University People’s HospitalDepartment of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesNational Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of GerontologyDepartment of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical SciencesDepartment of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Objective To evaluate the effects of surgical interventions on individuals diagnosed with bladder neuroendocrine carcinoma (BNEC). Materials and methods Data were gathered from the Surveillance, Epidemiology, and End Results (SEER) database for this retrospective analysis. No-surgery procedures included TURBT, cryotherapy, excisional biopsy, or partial cystectomy. Surgery was categorized as cystectomy, radical cystectomy, or a more complex surgical intervention, such as exenteration. A propensity score overlap weight (PSOW) analysis was performed to adjust statistical influences between the two groups. Prognostic factors related to cancer-specific survival (CSS) and overall survival (OS) were assessed using Cox proportional hazard regression. Results A total of 2,442 participants were divided into two groups: no-surgery group (n = 1860) and surgery group (n = 582). Individuals in the no-surgery cohort showed a preference for radiation therapy (29.5% compared to 6.7%), whereas individuals in the surgery cohort were more prone to receiving chemotherapy (71.5% compared to 56.6%) as part of their treatment regimen. Surgery was determined to have a strong correlation with increased rates of OS (hazard ratio (HR) = 0.564, 95% confidence interval (CI) = 0.497–0.639, P < 0.001) and CSS (HR = 0.628, 95% CI 0.539–0.732, P < 0.001) results in BNEC patients. After PSOW, 307 patients were selected for each group. Surgical intervention demonstrated a notable enhancement in OS (P < 0.001) and CSS (P < 0.001) than those patients in the no-surgery group. Among the chemotherapy population, the median survival of patients in the surgery group was significantly higher when compared to those in the no-surgery group. Furthermore, individuals diagnosed with stage I (OS, HR = 0.202, 95% CI 0.112–0.366, P < 0.001; CSS HR = 0.198, 95% CI 0.083–0.472, P < 0.001) and II (OS HR = 0.417, 95% CI 0.331–0.525, P < 0.001; CSS HR = 0.415, 95% CI 0.307–0.561, P < 0.001) tumors who underwent surgical procedures exhibited improved long-term survival rates, whereas no surgical advantage was evident in later stages. Conclusions In the early stages of BNEC, individuals who undergo surgery experience improved survival rates. Therefore, it is important to carefully consider surgical treatment for patients with advanced BNEC.https://doi.org/10.1186/s40001-025-02658-5Bladder neuroendocrine carcinomaSurgerySurvival outcomePropensity score overlap weightSEER
spellingShingle Jianyong Liu
Shicong Lai
Na Lu
Shuhang Luo
Runhua Tang
Lin Li
Pengjie Wu
Dongwen Wang
Jun Tian
The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study
European Journal of Medical Research
Bladder neuroendocrine carcinoma
Surgery
Survival outcome
Propensity score overlap weight
SEER
title The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study
title_full The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study
title_fullStr The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study
title_full_unstemmed The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study
title_short The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study
title_sort impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma a novel propensity score matched population based cohort study
topic Bladder neuroendocrine carcinoma
Surgery
Survival outcome
Propensity score overlap weight
SEER
url https://doi.org/10.1186/s40001-025-02658-5
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