Incidence and clinical characteristics of lower urinary tract symptoms as a presenting symptom for patients with newly diagnosed bladder cancer

Abstract

ARTICLE INFO ______________________________________________________________ ______________________Purpose: The incidence of lower urinary tract symptoms (LUTS) as the sole presenting symptom for bladder cancer has traditionally been reported to be low. The objective of this study was to evaluate the prevalence and clinical characteristics of newly diagnosed bladder cancer patients who presented with LUTS in the absence of gross or microscopic hematuria. Materials and Methods:We queried our database of bladder cancer patients at the Atlanta Veteran's Affairs Medical Center (AVAMC) to identify patients who presented solely with LUTS and were subsequently diagnosed with bladder cancer. Demographic, clinical, and pathologic variables were examined. Results: 4.1% (14/340) of bladder cancer patients in our series presented solely with LUTS. Mean age and Charlson Co-morbidity Index of these patients was 66.4 years (range = 52-83) and 3 (range = 0-7), respectively. Of the 14 patients in our cohort presenting with LUTS, 9 (64.3%), 4 (28.6%), and 1 (7.1%) patients presented with clinical stage Ta, carcinoma in Situ (CIS), and T2 disease. At a median follow-up of 3.79 years, recurrence occurred in 7 (50.0%) patients with progression occurring in 1 (7.1%) patient. 11 (78.6%) patients were alive and currently disease free, and 3 (21.4%) patients had died, with only one (7.1%) death attributable to bladder cancer. Conclusions: Our database shows a 4.1% incidence of LUTS as the sole presenting symptom in patients with newly diagnosed bladder cancer. This study suggests that urologists should have a low threshold for evaluating patients with unexplained LUTS for underlying bladder cancer.

Complications of radical cystectomy for bladder cancer

“…12 In study by Dobbs RW et al, 78.1% presentation with gross hematuria and 4.1% with LUTS. 10 The ratio of males to females in present study was 4.25:1, similar to the study by Horowitz D, et al, Pichler R et al, and Fedeli U et al, with male to female ratio of 3.6:1, 4.5:1 and 5:1 respectively. 7,13,14 However, in Gupta et al, series, male to female ratio was 8.6:1.…”

“…6,7 The median age of presentation in present study was 60 years comparable to studies by Taylor JA et al, Dhar N et al 8,9 Dobbs RW et al, with median age of 66, 61 and 67 years respectively. 10 In Gupta et al, a series of 561 bladder cancer patients treated between 2001 and 2008 at SGPGI, Lucknow, the mean age was 60.2±4.4years (range: 18-90 years old). 11 The commonest mode of presentation in present study was painless hematuria (71.4%) followed by both hematuria and dysuria (23.8 %) in comparable to study by Kumar V et al, where 55% presented with frank hematuria and 20% with irritative bladder symptoms.…”

Evaluation of clinical and laboratory characteristics of patients with bladder cancer in Ardabil province, 2016

“…In other studies in Iran and other places, the rate of cancer in male was more and the sex ratio was different from 3-8.6 to 1. 5,[18][19][20][21][22][23][24][25][26][27][28] In this study, the mean age of patients was 66.9±15.02 and similar to other studies there wasn't significant difference between two sexes. 7,[26][27][28][29][30][31][32][33][34] More than 90% of patients in this study have age up 50 years that in a study in Iran during 2003-2009, the most of incidence was seen in age group up 80 which in line with our study result.…”

Early Stage Bladder Cancer: Do Pathology Reports Tell Us What We Need to Know?

“…Demographics of the patients are as expected 1,18 for a population of Veterans with bladder cancer, with 99% male and mean age of 78 (see Table 1). …”