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Survival differences by ethnicity among patients diagnosed with bladder cancer

The Original Article was published on 30 March 2020

Dear Editor,

We read the study by Fang et al. [1] with great interest and would like to congratulate the authors for their superb study. The authors compared the oncologic outcomes of bladder cancer (BC) of different ethnicities, which may aid in clinical decision-making. As such, there are a few points that we would like to bring up.

  1. 1.

    Their study included patients with primary BC but did not exclude multiple primary cancers. However, another SEER-based study showed BC patients were at a significantly higher risk of developing a second malignancy, which may affect patients’ survival [2].

  2. 2.

    BC surgery in the SEER database includes transurethral resection of bladder, partial cystectomy and complete cystectomy, etc. It would be more meaningful to stratify patients according to the type of surgery that they received; in this way, readers can easily see which surgical treatment improves BC patient’s survival better.

  3. 3.

    Some of the patients included in the analysis received radiotherapy or chemotherapy. These two types of treatment should be taken into consideration since prior studies showed that both radiotherapy and chemotherapy hold great potential in the management of BC patients [3, 4].

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Bladder cancer


  1. Fang W, Yang ZY, Chen TY, Shen XF, Zhang C. Ethnicity and survival in bladder cancer: a population-based study based on the SEER database. J Transl Med. 2020;18(1):145 (Epub 2020/04/02. Eng).

    Article  CAS  Google Scholar 

  2. Khanal A, Budhathoki N, Singh VP, Shah BK. Second primary malignancy in bladder carcinoma—a population-based study. Anticancer Res. 2017;37(4):2033–6 (Epub 2017/04/05. Eng).

    Article  Google Scholar 

  3. Diaz DA, Pollack A, Reis IM, Mahmoud O, Gonzalgo ML, Ishkanian A, et al. Neoadjuvant radiotherapy improves survival in patients with T2b/T3 bladder cancer: a population-based analysis. Clin Genitourin Cancer. 2015;13(4):378–84 (Epub 2015/04/25. Eng).

    Article  Google Scholar 

  4. Galsky MD, Stensland KD, Moshier E, Sfakianos JP, McBride RB, Tsao CK, et al. Effectiveness of adjuvant chemotherapy for locally advanced bladder cancer. J Clin Oncol. 2016;34(8):825–32 (Epub 2016/01/21. Eng).

    Article  CAS  Google Scholar 

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The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


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BG reviewed the relevant study and drafted this letter. ML revised this letter for critical content and scientific rigour. Both authors read and approved the final manuscript.

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Correspondence to Ming Liu.

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Guo, B., Liu, M. Survival differences by ethnicity among patients diagnosed with bladder cancer. J Transl Med 18, 486 (2020).

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