Urothelial carcinoma of the urinary bladder in young adults--clinical experience at Taipei Veterans General Hospital.
BACKGROUND
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.


METHODS
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.


RESULTS
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%.


CONCLUSIONS
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.
Division of Urology, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
Yu-Ching
YC
Wen
Junne-Yih
JY
Kuo
Kuang-Kuo
KK
Chen
Alex T L
AT
Lin
Yen-Hwa
YH
Chang
Yen-Shen
YS
Hsu
Luke S
LS
Chang
D000328:Adult; D000367:Age Factors; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D019459:Urothelium / Q000473:pathology