Carcinoma of Urinary Bladder in Young Patients

Abstract

Introduction:  Urothelial carcinoma of urinary blad-der is rare before age of 40 years. The issue regarding age is critical because the behavior of tumor at diffe-rent age group is a matter of great debate. Our study aimed to see the grade and stage of disease at the time of presentation and its recurrence as well as progress-ion after 3 month at first check cystoscopy in young patients.

Method:  We prospectively analyzed our newly diag-nosed twenty consecutive patients up to 40years of age (16 males – 04 females) with urothelial carcinoma of urinary bladder, who were treated at our hospital. The data was reviewed regarding age of patients, stage and grade of tumor at time of presentation. The recurrence and progression after 3 months at first check cysto-scopy was noted.

Results:  Twenty consecutive patients of 21 to 40 years of age who were diagnosed as urothelial carcino-ma of urinary bladder were analysed.The mean age at time of diagnosis was 32.2 years , male to female ratio was 4; 1. Painless hematuria was a predominant symp-tom in all cases, while 20% (n – 4) had irritative symp-toms along with hematuria. The stage at first resection was as pTa (60%), pT₁ (20%), pT₂a (10%) and pT₂b (10%). The grade of disease at initial diagnosis was low grade in 90% of cases (well differentiated in 60% of cases, moderately differentiated in 30%) while 10% had high grade disease. At first check cystoscopy after 3 month only 2 patients had recurrence out of 16 pati-ents who had superficial disease. The remaining four patients who had muscle invasive disease were advised radiotherapy / radical cystectomy. They opted radio-therapy. Among these four patients two came on fol-low up and their cystoscopy reveal a very small recur-rence which was resected. The remaining two did not turn up for follow up. No progression was noted.

Conclusion:  Biological behavior of urothelial bladder cancer depends upon stage and grade. The young pati-ents have good prognosis as they are having low grade and stage.