Clinical, Pathological Characteristics and Progression of Urothelial Bladder Cancer in Young Adult Patients. Our Experience and Literature Review

• Sonia Pérez González ^[2] ; Virginia Del Rosario Rodríguez ^[2] ; Victoria Heredia Soto ^[1] ; Marta Mendiola Sabio ^[3] ; Manuel Girón de Francisco ^[4] ; Elia Pérez Fernandez ^[5] ; Rubén Casans Francés ^[6] ; Pilar González Peramato ^[7]
  1. [1] Hospital Universitario La Paz

     Hospital Universitario La Paz

     Madrid, España

     
  2. [2] Department of Urology, Infanta Leonor University Hospital, 28031 Madrid, Spain
  3. [3] Center for Biomedical Research in the Cancer Network (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain
  4. [4] Department of Urology, La Paz University Hospital, 28046 Madrid, Spain
  5. [5] Research Unit, Alcorcón Foundation University Hospital, 28922 Madrid, Spain
  6. [6] Department of Anesthesia and Pain Medicine, Infanta Elena University Hospital, 28342 Madrid, Spain
  7. [7] Department of Pathology, La Paz University Hospital, 28046 Madrid, Spain

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• Localización: Archivos españoles de urología, ISSN 0004-0614, Tomo 77, Nº. 5, 2024, págs. 463-470
• Idioma: español
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• Resumen

  • Background: Bladder cancer is highly prevalent even though its incidence is considerably lower in patients younger than 40 years, thus raising the issue of the influence of age at diagnosis on the natural history of this disease. This study aimed to evaluate the characteristics and progression of young patients with urothelial bladder carcinoma with at least 10 years of follow-up and to compare the results with those of previously reported studies.

    Material and Methods: A retrospective study between 1990 and 2007 was conducted. The medical records and tissue samples of patients with urothelial bladder tumours were reviewed, and patients with a first diagnosis of urothelial carcinoma of the bladder at age 40 years or younger were selected. Their clinical and pathological data and disease-free survival were analysed.

    Results: This study included 43 patients, with a median follow-up of 152 months (interquartile range (IQR): 96–222) and a mean age at diagnosis of 34 years (SD: 4.6). Thirty-five patients (81.4%) had non-muscle invasive tumours at diagnosis, and 53.5%, 27.9% and 18.6% had tumour grades of G1, G2 and G3, respectively. Fifteen patients (34.9%) experienced recurrence, and eight (18.6%) progressed. At 24 and 60 months, the recurrence-free survival rates were 84.8% (95% confidence interval (CI): 69.2%–92.9%) and 68.9% (95% CI: 51.7%–81%), respectively, and the progression-free survival rates were 94.9% (95% CI:

    81%–98.7%) and 92.2% (95% CI: 77.8%–97.4%), respectively.

    Conclusions: Bladder cancer is an uncommon disease in young patients. In most cases, it consists of non-muscle-invasive tumours, with a low rate of recurrence and progression. The prognosis is based on the tumour’s characteristics and not on the patient’s age.