Survival improvements and disparities in metastatic prostate adenocarcinoma, clear cell renal cell carcinoma, and urothelial carcinoma of bladder.

Over the past two decades, treatment advancements have significantly changed the management of metastatic prostate cancer (PCa), clear cell renal cell carcinoma (ccRCC), and urothelial carcinoma of the bladder (UCB), but it remains unclear how these advancements have translated into survival improvements at the population level. In this study, newly diagnosed cases of metastatic PCa, ccRCC, and UCB were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier curves and multivariable Cox regression were used to estimate cancer-specific survival (CSS) improvement during 2000-2019. For metastatic PCa, there was no significant improvement in CSS for patients diagnosed in 2005-2009 compared to 2000-2004 (HR = 0.95, 95% CI, 0.88-1.02), but significant improvements were observed in 2010-2014 (HR = 0.93, 95% CI, 0.88-0.98) and 2015-2019 (HR = 0.75, 95% CI, 0.70-0.82). For metastatic ccRCC, compared to 2000-2004, patients diagnosed in 2005-2009 (HR = 0.87, 95% CI, 0.81-0.94), 2010-2014 (HR = 0.77, 95% CI, 0.71-0.83), and 2015-2019 (HR = 0.55, 95% CI, 0.51-0.60) showed continuous CSS improvement. For metastatic UCB, no significant improvement was shown in 2005-2009 (HR = 1.01, 95% CI, 0.92-1.10) or 2010-2014 (HR = 0.92, 95% CI, 0.85-1.00), but significant improvement emerged in 2015-2019 (HR = 0.83, 95% CI, 0.76-0.90). Subgroup analysis revealed a "catch-up" effect among Black patients, who generally had poorer outcomes but demonstrated greater improvements in CSS than White patients in metastatic PCa, ccRCC, and UCB. Overall, survival has improved for patients with metastatic PCa, ccRCC, and UCB between 2000 and 2019, but the extent of improvement varies across different socioeconomic groups.