Genç populasyonda mesane tümörlerinin klinik ve patolojik özellikleri

Year 2020, Volume: 12 Issue: 2, 135 - 140, 23.07.2020

Sercan Yılmaz Ali Yıldız Serdar Yalçın Can Sicimli Ali Fuat Çiçek Bahadır Topuz Selahattin Bedir

Abstract

Amaç: Mesane kanserinin çocuklarda ve genç eriskinlerde görülme prevalansı ise %1’den azdır. Genç populasyonda görülen mesane kanserinin klinik davranışıyla ilgili literatürde yeterli kanıt bulunmamaktadır. Bu çalışmadaki amacımız; kliniğimizde 40 yaş altındaki hastalarda görülen mesane tümörlerinin klinik seyrini ve histopatolojik özelliklerini değerlendirmekti.

Gereç ve Yöntemler
2000-2020 yılları arasında kliniğimizde mesane neoplazisi tanısı alarak opere edilmiş hastaların klinik ve histopatolojik verileri retrospektif olarak incelendi. Tümörün histopatolojisi, anatomik topografisi, evresi, derecesi, hastaya uygulanan tedavi, risk faktörleri, tümör rekürrensi, progresyonu ve ortalama takip süreleri kayıt altına alındı.

Bulgular
Çalışmaya toplam 88 hasta dahil edildi. Histopatolojik sonuçlar değerlendirildiğinde hastaların %51.1’inin malign raporlandığı gözlendi. Papiller ürotelyal karsinoma ise en sık gözlenen ürotelial karsinoma alt tipi olarak dikkat çekti. Değişici epitel hücreli mesane kanseri olan hastaların %97.7’sinde Ta, %95.3’ünde düşük dereceli tümör mevcuttu. Tüm hastalar gözönüne alındığında nüks oranı %23.8, progresyon oranı ise %14.2 olarak hesaplandı.

Sonuç Genç yaşta teşhis edilen mesane tümörleri düşük patolojik evrede olma eğilimindedir ve nispeten düşük nüks, progresyon oranları vardır. Bu nedenle; bu yaş grubundaki hastalarda daha konservatif yaklaşımlar tercih edilmeli ve tedavi sonrası yakın bir şekilde takip edilmelidir.

Keywords

genç, kanser, mesane, neoplazm

Clinical and pathological features of bladder tumors in the young population

Abstract

Introduction
The prevalence of bladder cancer in children and young adults is less than 1%. There is not enough evidence about clinical behavior of bladder cancer in younger patients. Our aim in this study; To evaluate the clinical behaviour and histopathological features of bladder tumors in patients under 40 years old in our clinic. Histopathology, anatomical topography, stage, grade, treatment, risk factors, tumor recurrence, progression and mean follow-up times were recorded.

Material and methods
The clinical and histopathological data of the patients who were operated in our clinic between 2000-2020 with the diagnosis of bladder neoplasia were analyzed retrospectively.

Results
A total of 88 patients were included in the study. When histopathological results were evaluated, 51.1% of patients were reported to be malignant. Papillary urothelial carcinoma was the most common subtype of urotelial carcinoma. There was Ta tumor in 97.7%, low grade tumor in 95.3% of patients with transitional cell bladder cancer. When we consider all of the patients, the recurrence rate was 23.8%, and the progression rate was 14.2%.

Conclusion
Bladder tumors diagnosed at young age tend to be at a low pathological stage and have relatively low recurrence, progression rates. Therefore; more conservative approaches should be preferred in patients in this age group and should be followed up closely after treatment.

Keywords

bladder, cancer, neoplasm, young

References

• 1. Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F. Bladder cancer incidence and mortality: a global overview and recent trends. Eur Urol 2017;71:96-108.
• 2. Ferlay J. GLOBOCAN 2012. Estimated cancer incidence, mortality and prevalence worldwide in 2012.
• 3. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, Bladder Section, 1975‑2008. Bethesda, MD: National Cancer Institute; 1975‑2008.
• 4. Wen YC, Kuo JY, Chen KK, et al. Urothelial carcinoma of the urinary bladder in young adults-Clinical experience at Taipei Veterans General Hospital. J Chin Med Assoc 2005;68:272‑5.
• 5. J. A.Witjes and K.Hendricksen. Intravesical pharmacotherapy for non-muscle-invasive bladder cancer: a critical analysis of currently available drugs, treatment schedules, and long-term results. European Urology 2008;53:45-52.
• 6. Na SW, Yu SH, Kim KH, et al. The prognosis of patients less than 40 years with bladder cancer. J Cancer Res Ther 2014;10:710-14.
• 7. M. Nomikos, A. Pappas, M.-E. Kopaka et al. Urothelial carcinoma of the urinary bladder in young adults: presentation, clinical behavior and outcome. Adv Urol 2011;2011:480738.
• 8. E. Comperat, S. Larre, M. Roupret et al. Clinicopathological characteristics of urothelial bladder cancer in patients less than 40 years old. Virchows Archiv 2015;466,5: 589–594.
• 9. S. Poletajew, M. Walędziak, Ł. Fus. Urothelial bladder carcinoma in young patients is characterized by a relatively good prognosis. Upsala Journal of Medical Sciences 2012;117,1:47–51.
• 10. B. Gunlusoy, Y. Ceylan, T. Degirmenci et al. Urothelial bladder cancer in young adults: diagnosis, treatment and clinical behaviour. Can Urol Assoc 2015;9,9-10:727-730.
• 11. H.Huang,M. Sun, X. Li, and J. Jin. Urothelial carcinoma of the bladder in patients aged 30 years or younger: clinicopathological analysis and expression of fibroblast growth factor receptor 3 (FGFR3) of 45 cases. Medical Oncology 2015;32,5: article 137.
• 12. QH Wang, ZG Ji, HZ Li et al. Clinicopathologic comparison of urothelial bladder carcinoma in young and elder patients. Pathology and Oncology Research 2016;22,1:67-70.
• 13. Turkeri L, Mangır N, Gunlusoy B, et al. Identification of patients with microscopic hematuria who are at greater risk for the presence of bladder tumors using a dedicated questionnaire and point of care urine test - a study by the members of association of urooncology, Turkey. Asian Pac J Cancer Prev 2014;15:6283-6.
• 14. Ozbey I, Aksoy Y, Bicgi O, Polat O, Okyar G. Transitional cell carcinoma of the bladder in patients under 40 years of age. Int Urol Nephrol 1999;31:655-59.
• 15. Shi B, Zhang K, Zhang J, Chen J, Zhang N, Xu Z. Relationship between patient age and superficial transitional cell carcinoma characteristics. Urology 2008;71:1186-90.
• 16. Aben KK, Kiemeney LA. Epidemiology of bladder cancer. Eur Urol 1999;36:660-72.
• 17. Brauers A, Jakse G. Epidemiology and bilogy of human urinary bladder cancer. J Cancer Res Clin Oncol 2000;126:575-83.
• 18. Cohen SM, Shirai T, Steineck G. Epidemiology and etiology premalignant and malignant urothelial changes. Scand J Urol Nephrol Suppl 2000;205:105-12.
• 19. Cheng L, Weaver AL, Leibovich BC, et al. Predicting the survival of bladder carcinoma patients treated with radical cystectomy. Cancer 2000;88:2326-32.
• 20. A. Otunctemur, I. Koklu, E. Ozbek et al. Are bladder neoplasms more aggresive in patients with a smoking-related second malignancy?. Asian Pac J Cancer P 2014;15,9:4025-4028.
• 21. ND Freedman, DT Silverman, AR Hollenbeck, A Schatzkin, CC Abnet. Association between smoking and risk of bladder cancer amongmen and women. JAMA 2011;306,7:737-745.
• 22. GP Paner, P Zehnder, AM Amin, AN Husain, MM Desai. Urothelial neoplasms of the urinary bladder occurring in young adult and pediatric patients: a comprehensive review of literature with implications for patient management. Adv Anat Pathol 2011;18,1:79-89.
• 23. Alabdulkareem AI, Al-Jahdali FH, Nazers AI, Alkhateeb SS. Characteristics of bladder neoplasms in the young population of Saudi Arabia. Urol Ann. 2017;9(4):343‐347.
• 24. Yossepowitch O, Dalbagni G. Transitional cell carcinoma of the bladder in young adults: presentation, natural history and outcome. J Urol 2002;168:61-6.
• 25. Murphy WM, Grignon DJ, Perlman EJ. Tumors of the Kidney, Bladder, and Related Urinary Structures. Washington, DC: American Registry of Pathology; 2004. p. 394.
• 26. Ackerman LV, Rosai J. Surgical Pathology. 5. Saint Louis: C. V. Mosby Company; 1974. Soft tissues; pp. 1146–1147.
• 27. Shapiro E, Strother D. Pediatric genitourinary rhabdomyosarcoma. J Urol. 1992;148:1761–1768. doi: 10.1016/S0022-5347(17)37023-4.
• 28. Grignon DJ. Neoplasms of the urinary bladder. In: Bostwick DG, Eble JN, editors. Urologic surgical pathology. St. Louis: Mosby-Year Book, Inc; 1997. pp. 214–305.