Histotype-specific incidence and survival of urothelial carcinoma—an analysis of the German North Rhine-Westphalia Cancer Registry

Background: The aim of this study was to evaluate the incidence and survival of urothelial carcinoma (UC) and non-urothelial tumor types. The primary objective was to define the incidence and survival of pure UC and non-UC tumor types. Materials and methods: Malignant invasive urinary cancers of the urothelial tract diagnosed between 2008 and 2022 were identified via the North Rhine-Westphalia Cancer Registry and classified according to the 2016 World Health Organization (WHO) classification (fourth edition). Evaluation focused on pure tumor types: UC, papillary invasive UC (PIUC), squamous-cell carcinoma (SCC), adenocarcinoma (ADC), rarer tumor types and mixed histologies grouped under other specific tumor types (OSTT), and unspecified tumor types (UTT). The primary outcomes were age-standardized incidence rate with estimated annual percentage changes, and relative survival. Results: = 73 751), respectively. The age-standardized incidence of PIUC and UTT decreased over time in both sexes, while OSTT incidence increased over time. Incidence rate declined among men with SCC and among women with ADC. Relative survival was notably poor for SCC (32.3%) and OSTT (23.8%), in contrast to a more favorable outcome for PIUC (72.0%). Decreasing survival with advancing T-stages was noted, particularly for UC, PIUC, ADC, and UTT; T1 in PIUC showed the best survival (81.0%) and T3-4 in OSTT had the poorest survival (16.4%). Conclusion: Relative survival was most favorable for PIUC, UC, and ADC. In contrast, SSC and OSTT exhibited poorer survival outcomes, highlighting a pressing medical need for enhanced treatment options for these subgroups.