Urothelial bladder cancer in young adults: Diagnosis, treatment and clinical behaviour

Abstract

Introduction: The aim of the study is to reveal pathologic characteristics and clinical behaviour of patients 40 years old or younger diagnosed with and treated for urothelial bladder carcinoma. Methods: We retrospectively analyzed the clinical and pathologic data of 91 patients, initially diagnosed and treated at our institution from May 1996 to December 2014. Cancer recurrence was defined as new occurrence of bladder cancer at the same or different sites of the bladder. Cancer progression was defined as an increase in stage or grade in any of the recurrences. Results: The mean age was 33.8 (range: 17-40) years. The pathological examination after transurethral resection revealed 83 (91.2%) patients with non-muscle invasive urothelial bladder cancer, and 8 (8.8%) patients with muscle invasive urothelial bladder cancer. According to the distribution of grade, there were 75, 4 and 12 patients with grade 1, grade 2 and grade 3 diseases, respectively. Initial cancer staging was: pTa with 40 patients (43.9%), pT1 with 43 patients (47.2%), pT2 with 7 patients (7.6%), and pT3 with 1 patient (1.2%). While 17 (18.6%) patients recurred in the followup, 10 (10.9%) patients had progression. There were no differences in recurrence and progression rates in the Ta and T1 stages between groups (p = 0.233, p = 0.511, respectively). Conclusion:The risk of progression increased as the number of relapses increased. The clinical behaviour of high-stage and highgrade disease in younger patients is similar to the older group.

Molecular Pathologic Subtyping of Urothelial Bladder Carcinoma in Young Patients

“…20 Conflicting data regarding genetic factors, outcomes, and prognosis of early-onset urothelial cancer could be explained by the fact that there is no consensus on the definition of the cutoff threshold for "young patients"; some studies restrict analysis to patients younger than 20 years of age, other studies indicate the threshold of young age to be 25 or 30 years, while some authors include patients in this category up to 45 years of age. 17,[21][22][23][24][25][26] In our study, we analyzed patients younger than 45 years of age according to the World Health Organization standard age groups. We also stratified our cohort into subgroups by decades for statistical analysis.…”

Bladder Cancer to Patients Younger than 30 Years: A Retrospective Study and Review of the Literature

“…Urothelial carcinoma is a disease that typically affects the elderly (1-4). Bladder cancer constitutes a rare entity in patients younger than 40 years and even rarer in patients younger than 30 years (1, 3-6). The incidence of bladder cancer in patients younger than 40 years is reported to be 1-2.4%, while in patients younger than 20 is only 0.1-0.4% (1).…”

Characteristics of bladder neoplasms in the young population of Saudi Arabia

“…Our analysis showed that patients with bladder malignancy aged ≤40-year-old often have a low-stage (63.2%) and low-grade (44.7%) tumor, which supports the previous evidence that patients at this age group had low stage and grade. [ 6 7 8 9 10 11 ] Tumor stage and grade is important in determining the natural history of the disease as well as the risk of recurrence. Compérat et al .…”