Bladder In Young Adults Research Articles

Transitional Cell Carcinoma of the Bladder in Young Adults: Presentation, Natural History, and Outcome of 158 Cases

Transitional Cell Carcinoma of the Bladder in Young Adults: Presentation, Natural History, and Outcome of 158 Cases

Urothelial Carcinoma of the Urinary Bladder in Young Adults: Presentation, Clinical behavior and Outcome

Introduction. There is not much evidence regarding clinical behavior of bladder cancer in younger patients. We evaluated clinical characteristics, tumor recurrence and progression in patients younger than 40 years old with urothelial bladder carcinoma. Methods. We retrospectively reviewed the medical records of 31 patients less than 40 years old who were firstly managed with bladder urothelial carcinoma in our department. Data were analysed with the Chi-square test. Results. Mean age was 31.7 years. Mean followup was 38.52 months (11–72 months). Nineteen (61%) patients were diagnosed with GII and 2 (6%) patients with GIII disease. Five (16%) patients presented with T1 disease. Three (9%) patients with invasive disease underwent cystectomy and adjuvant chemotherapy and one developed metastatic disease. Ten (32%) patients recurred during followup with a disease free recurrence rate of 65% the first 2 years after surgery. From those, 1 patient progressed to higher stage and three to higher grade disease. No patient died during followup. Conclusions. Bladder urothelial carcinoma in patients younger than 40 years is usually low stage and low grade. Management of these patients should be according to clinical characteristics and no different from older patients with the same disease.

POS-02.146: Transitional cell carcinoma of bladder in young adults

Increasing prevalence of Carcinoma of Bladder in young adults in our area (Larkana).

UROTHELIAL NEOPLASMS IN PATIENTS 20 YEARS OR YOUNGER: A CLINICOPATHOLOGICAL ANALYSIS USING THE WORLD HEALTH ORGANIZATION 2004 BLADDER CONSENSUS CLASSIFICATION

Urothelial neoplasms in patients younger than 20 years are rare, with conflicting data regarding clinical outcomes. We identified 23 patients 4 to 20 years old with urothelial neoplasms, reclassified the microscopic diagnoses using the 2004 WHO/International Society of Urologic Pathology grading classification and collected data on presentation, risk factors and outcomes. Pathological grading revealed 2 urothelial papillomas, 10 papillary urothelial neoplasms of low malignant potential (PUNLMPs), and 8 low grade and 3 high grade papillary urothelial cancers, all without invasion. Mean patient age was 13.2 years (range 4 to 20), 19 patients were male and 19 presented with gross hematuria. All lesions were solitary and measured 0.1 to 6 cm. One patient had a history of smoking and 1 had parents who smoked. Three patients (13%) had recurrences classified as either urothelial papilloma (1) or PUNLMP (2). All patients were alive with no evidence of disease after a mean followup of 4.5 years (range 6 months to 13 years). Urothelial neoplasms in individuals younger than 20 years more commonly occur in males and are predominantly low grade with a favorable clinical outcome. Before the current classification system the 10 patients with a diagnosis of PUNLMP would have been classified as having papillary carcinoma. Thus, the diagnostic category of PUNLMP allowed 43.5% of patients in this series to avoid being labeled with "cancer" at a young age.

Urothelial Carcinoma of the Urinary Bladder in Young Adults — Clinical Experience at Taipei Veterans General Hospital

The clinical behavior and prognosis of bladder cancer in young patients is not well defined. The aim of this study was, therefore, to evaluate the clinical behavior, pathologic characteristics and prognosis of urothelial carcinoma of the urinary bladder in young adults. We retrospectively reviewed records from 30 young patients (23 males, 7 females; age < or = 40 years) with urothelial carcinoma of the urinary bladder who had been treated in our hospital between May 1990 and October 2003. Data were analyzed by the Kaplan-Meier method to assess disease recurrence and survival. The mean age at diagnosis was 34.3 +/- 5 years (range, 22-40 years). Fifteen patients presented with pTa, 9 with pT1, 4 with pT2, 1 with pT3, and 1 with pT4. Twenty-six patients (87.2%) had low-grade bladder cancer, and the other 4 had high-grade disease. The most frequent initial presenting symptom was gross hematuria. The mean postoperative follow-up period was 72.8 months (range, 4-149 months). Fifty percent of superficial bladder cancers recurred a mean of 10.7 months (range, 3-68 months) after operation. One patient died from invasive bladder cancer after radical cystectomy, and 1 died from superficial bladder cancer due to tumor progression. The 5-year cancer-specific survival rate was 95.2% for superficial cancer and 83.3% for invasive cancer. The overall survival rate was 93.3%. Urothelial carcinoma of the urinary bladder in young adults is usually associated with low grade and low stage. Invasive bladder cancer had no worse a survival rate than superficial bladder cancer.

Transitional cell carcinoma of the bladder in young adults: Presentation, Natural History and Outcome

Transitional cell carcinoma of the bladder in young adults: Presentation, Natural History and Outcome

Transitional cell carcinoma of the bladder in young adults: Presentation, Natural History and Outcome

The natural history and prognosis of bladder cancer in young patients is not well defined. We analyzed our experience with such patients. The medical records of 74 patients presenting with transitional cell carcinoma of the bladder at 40 years and younger were reviewed and compared with those of 75 patients diagnosed with bladder transitional cell carcinoma at 65 years old and older. Median followup was 28.1 months (range 1 to 155) and 34.7 (range 1 to 178) in young and old patients, respectively. Initial stage distribution was similar with 80% of patients presenting with superficial disease. No difference was observed in the disease-free progression or disease-free recurrence rate among the groups in patients initially presenting with stage Ta, Tis or T1 tumors. A significantly higher proportion of older versus younger patients underwent cystectomy (54% versus 23%). We did not observe a difference in pathological stage distribution or the rate of extravesical disease in young and old patients (47% and 45%, respectively). Younger patients who ultimately underwent radical cystectomy had significantly lower disease-free survival, mainly due to a higher rate of distant metastases than in the older group (41% versus 24%). The rate of local recurrence was similar. Bladder transitional cell carcinoma in young adults has a clinical stage distribution and natural history similar to that in older patients. Our study suggests that a subset of young patients who ultimately undergo radical cystectomy have particularly aggressive tumors, portending a poor outcome.

Transitional cell carcinoma of the bladder in patients under 40 years of age.

A review of our records between 1993 and 1998 identified 25 patients with transitional cell carcinoma of the bladder who were less than 40 years old, 22 males and 3 females. The youngest patient was 19 years old. At the time of diagnosis 16 patients had superficial (Ta/T1) and 9 had invasive disease. Twenty-four patients were followed up for a period of 3-71 months (mean: 19.2 months). The recurrence rate for patients with superficial disease was 12.5%, and the progression rate for patients with invasive disease was 77.7%. We concluded that the patients under 30 years of age presented with lower grade and lower stage disease than those over 30. Transitional cell carcinoma of the bladder in young adults has a natural history similar to that seen in older patients. Accordingly, all patients, regardless of age, should be treated as aggressively as necessary on the basis of the stage and the grade of the tumour.

Transitional cell carcinoma of the bladder in young adults.

A retrospective survey of young servicemen presenting with transitional cell carcinoma of the bladder aged 40 years or below is presented, 19 such patients having been identified over a 20-year period. The results were compared with those of other similar series. The tumour behaviour appears to vary with age at presentation, its propensity for multifocal presentation, recurrence, progression to invasion and mortality all rising over the first 4 decades of life. These trends appear to be linked to grade and stage at presentation, and also tend to rise with age rather than altered tumour behaviour. The follow-up of young adults should thus be the same as for older patients presenting with the same grade and stage tumours.

Bladder carcinoma in patients age 40 years or younger.

The records of 26 men and nine women aged 40 years or younger, with transitional cell carcinoma of the bladder, were reviewed. Twenty-eight of the patients presented with gross painless hematuria, and 30 were regular smokers. Twenty-two patients presented with noninvasive disease, five with superficial invasion and eight with deep invasion. The risk of the disease progressing to invasion increased with the grade of the tumor, rising from 24% with Grade 1 to 75% with Grade 3. The patients younger than 30 years presented with a lower grade and a lower stage disease than those older than age 30. Transitional cell carcinoma of the bladder in young adults has a natural history similar to that seen in older patients.