Retrospective analysis of clinico-epidemiological factors and clinical outcome in patients with urinary bladder carcinoma

Abstract

Background Bladder cancer ranks ninth in worldwide cancer incidence and it is the second most common malignancy among Egyptian males. Urothelial carcinoma (UC) of the bladder (previously known as transitional cell carcinoma; TCC)is the predominant histologic type, the two most well-established risk factors for bladder are cigarette smoking and occupational exposure to urothelial carcinogens. Aim of the Work To analyze retrospectively the clinico-pathological features of urinary bladder cancer patients treated in Clinical Oncology Department of Ain Shams University Hospitals in Egypt. Patients and Methods All 127 eligible patients fulfilling the inclusion criteria and the medical sheets were reviewed including history, clinical examination, routine laboratory tests, radiological investigations, and follow up. Several prognostic factors were analyzed in our study including age, sex, performance status, tumor size, site, grade, extent of surgery and type of treatment as regard chemotherapy and radiotherapy. Results Among the included 127 patients, populatge ranged from 30 to 75 years. Males represented 81.9 % of the patients with a male to female ratio of 4:1. Eastern Cooperative Oncology Group (ECOG) performance status of patients at presentation was ECOG 1 in 82 patients (64.6%). The majority of the studied population presented with haematuria. The most common histological subtype in biopsied specimens was transitional cell carcinoma in 75.5% of the patients.78 patients presented with non-metastatic and 47 patients with metastatic urinary bladder cancer. The median progression-free survival (PFS) was found to be 17 months and similarly the median overall survival (OS) was 17 months. In our study we found a significant correlation between age, performance status (PS), smoking, tumor stage and the treatment modalities such as surgery and adjuvant chemotherapy with the overall survival. Conclusion The epidemiology of bladder cancer was dramatically shifted in Egypt with a lower incidence of squamous cell carcinoma (SCC), a greater incidence of TCC and older age at diagnosis. Age, PS, smoking, tumor stage and the treatment modalities such as surgery and adjuvant chemotherapy were proved to affect the overall survival.