Non-invasive bladder cancer in younger patients: Results of long-term follow-up

Abstract

Purpose: The transitional cell carcinoma of the bladder (TCCB) is a rare disease below 35 years old patients. In our study, we aimed to present the treatment results and long-term follow-up process of younger patients. 

Materials and Methods: A 20 patients aged between 11-35 years were reviewed retrospectively. Intravesical epirubicin or mitomycin was administered to all of the patients within the first 12 hours in the postoperative period. The patiens were followed-up with cystoscopies according to the protocol. Abdominal computed tomography and Nuclear Matrix Protein-22 bladder control tests were performed once a year. 

Results: Amyloidosis mimicked bladder tumor was detected in one patient and this patient was excluded from the study. The mean age of the 9 male and 10 female patients was calculated as 25.1 (11-35) years and the mean duration of follow-up was calculated as 67.4 (42-96) months. All of the patients had single tumoral focus and mean tumor size was calculated as 2.55 (1-4) centimeters. According to the TNM classification, 2 (10.5%) patients were reported as benign papilloma, 15 (78.9%) patients as Ta, and 2 (10.5%) patients as T1. Intravesical Bacillus Calmette Guerin (BCG) was administered to 2 (10.5%) patients whose pathologies were recorded as T1. After sixth doses of intravesical BCG, relapses occurred in these 2 patients. Intravesical BCG therapy was started again, and no relapses were observed in subsequent follow-ups. NMP-22 test yielded positive results only in 2 (10.5%) patients with relapses. In addition, progression was not observed in any of patients below 35 years old. 

Conclucions: According to the related literature and the clinical results of the current study, TCCB appears as low grade in younger ages with better prognosis at long-term follow-up. 

Keywords

• Bladder cancer
• Pathology
• Prognosis
• Younger patient

Genç hastalarda invaziv olmayan mesane kanseri: Uzun dönem takip sonuçları

Abstract

Amaç: Mesanenin transizyonel hücreli karsinomu 35 yaş altında nadir görülen bir hastalıktır. Çalışmamızda, genç yaştaki hastaların uzun dönem tedavi sonuçlarını ve takiplerini sunmayı amaçladık. 

Gereç ve Yöntem: Yaşları 11-35 arası değişen, mesane tümörü tanısı almış 20 hastanın verileri retrospektif olarak incelendi. Tüm hastalara post-operatif ilk 12 saat içinde intravezikal epirubicin veya mitomicin kemoterapisi uygulandı. Hastalara evrelerine göre uygun protokolde kontrol sistoskopisi yapıldı. Hastalar yılda bir kez bilgisayarlı tomografi ve Nükleer Matriks Proteini-22 testi ile takip edildi. 

Bulgular: Bir hastada mesane tümörünü taklit eden amiloidoz saptandı ve hasta çalışma dışı bırakıldı. Çalışma kapsamında değerlendirilen 9 erkek ve 10 kadın hastanın ortalama yaşı 25.1 (11-35) yıl, ortalama takip süresi 67.4 (42-96) ay olarak hesaplandı. Hastaların tamamında tek odakta tümör mevcut olup, ortalama tümör boyutu 2.55 (1-4) santimetre olarak ölçüldü. TNM sınıflamasına göre 2 (%10.5) hastada benin papilloma, 15 (%78.9) hastada Ta patoloji, 2 (%10.5) hastada T1 patoloji rapor edildi. Patoloji sonucu T1 olarak rapor edilen 2 (%10.5) hastaya intravezikal Bacillus Calmette Guerin (BCG) tedavisi uygulandı. Altı haftalık BCG uygulaması sonrası relaps meydana gelen bu hastalara BCG tedavisi yeniden başlandı ve takiplerinde nüks görülmedi. NMP-22 testi sadece relapsı olan 2 hastada pozitif olarak saptandı. Ayrıca 35 yaş altındaki bu hastaların hiçbirinde progresyon da izlenmedi. 

Sonuçlar: Güncel literatürlerin ve mevcut çalışmamızın sonuçlarına göre; mesanenin transizyonel hücreli karsinomunun, genç hastalarda düşük dereceli ve uzun dönem takiplerde iyi prognozlu olduğu görülmektedir. 

Keywords

• Mesane kanseri
• Pa- toloji
• Prognoz
• Genç hasta

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