title: Nonmuscular Invasive Urothelial Carcinoma of the Bladder in Pediatric and Young Adult Patients: Age-related Outcomes.
abstract: OBJECTIVE
  To report 2 pediatric urology referral centers' experience on transitional cell carcinoma of the bladder (TCCB) in patients younger than 30 years, focusing on age-related prognostic factors.
  
  
  METHODS
  Patients younger than 30 years affected by TCCB from January 1999 to December 2011 were investigated. Spearman's rank test and Kruskal-Wallis test were adopted for statistical analysis.
  
  
  RESULTS
  Eighteen patients were identified (8 females, 10 males) and stratified by age at presentation: 5 in group A (12 years old and younger), 7 in group B (13-19 years), and 6 in group C (20-29 years). Females were predominant in groups A and B, whereas males were predominant in group C. Pathological grading revealed low-grade papillary urothelial carcinoma in 7, papillary urothelial neoplasm of low malignant potential in 7, and high-grade urothelial papillary carcinoma in 4 patients. At a mean follow-up of 6.5 years, recurrence was observed in 2 cases. Statistical analysis showed a positive correlation between age and grading. There was no statistical significance based on gender. Staging was significant between the age groups; older patients had more advanced tumors.
  
  
  CONCLUSIONS
  TCCB is rarely observed in the first 3 decades of life. The prognosis is good in early-age presentation. Sex distribution, pathological grading, and prognosis were found different according to age. Patients younger than 19 years behave in a more favorable manner than those older, and should be followed up like adults.
authors.affiliation: Division of Urological Surgery, Department of Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Caione
authors.affiliation: Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy. Electronic address: g.patruno@gmail.com.
authors.forename: Giulio
authors.initials: G
authors.lastname: Patruno
authors.affiliation: Division of Urology and Andrology, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pagliarulo
authors.affiliation: Division of Urological Surgery, Department of Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Anna Lavinia
authors.initials: AL
authors.lastname: Bulotta
authors.affiliation: Division of Urological Surgery, Department of Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Salerno
authors.affiliation: Division of Pediatric Pathology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Diomedi Camassei
authors.affiliation: Division of Urology and Andrology, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lastilla
authors.affiliation: Division of Urological Surgery, Department of Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Gerocarni Nappo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009017:Morbidity / Q000639:trends; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000473:pathology*; D019459:Urothelium / Q000473:pathology*; D055815:Young Adult