Urothelial bladder cancer in young versus older adults: Presentations, clinical characteristics, and outcomes

Abstract

Background and objective: Urothelial bladder carcinoma is a common malignancy but rarely occurs at young ages and can occur more frequently in the older group. The majority of bladder cancer consist of urothelial bladder carcinoma. This study aimed to review the clinical presentation, histopathological features, staging, grading, and the progression and recurrence of urothelial bladder cancer in patients aged below 40 years compared with older patients. Methods: We retrospectively analyzed and reviewed 105 newly diagnosed patients with urothelial bladder carcinoma between August 2014 to January 2020 in a private clinic and Rizgary Teaching Hospital, Erbil city, Iraq. Results: The mean age ± SD of the cases was 56.2 ± 19.37 years, ranging between 18 – 85 years. Patients were divided according to age into two main groups, Group I (29 patients) were aged ≤ 40 years, and Group II (76 patients) were above 40 years. Most cases (72.4%) were males, but there was no significant gender distribution difference between the two groups (P = 0.327). Gross hematuria was the most common presenting symptom in both groups. In Group I, the proportion of patients who ever smoked was 79.3%, and 47.4% in Group II (P = 0.003).A significantly higher proportion of patients with lower grade and stage and small tumor size was detected in Group I than in Group II (P <0.05). The recurrence rate of Group II (36.8%) was significantly higher than that (6.9%) of Group I (P = 0.002). Conclusion: Urothelial bladder carcinomas among young patients were of lower grade, stage, and size than in older patients. The recurrence rate was higher among the older patients.