CHARACTERISTICS OF TRANSITIONAL CELL CARCINOMA OF THE BLADDER IN YOUNG ADULTS

Introduction: The incidence of transitional cell carcinoma of the bladder is increasing especially in all industrialized countries and an augmented number of young patients are encountered. It has long been a subject of debate whether younger patients have a better prognosis than their older counterparts. Materials and Methods: We retrospectively reviewed the charts of 26 consecutive patients 40 years and younger with bladder cancer treated at our institution from 1995 to 2006. Demographic data, initial transurethral resection pathology, recurrence and progression events, intravesical instillation, radical cystectomy data, local and distal recurrence, adjuvant therapies and disease status were recorded. All patients were evaluated by ultrasonography, cystoscopy and transurethral resection procedure. Patients were followed up every 3 mounts in first year, every 6 mounts in second year and every year thereafter. Results: In our retrospective series, macroscopic and microscopic hematuria were the most common signs (n: 23/n:3). Other rare signs were dysuria, pelvic pain, pollacuria and back pain. The smokers' ratio was high as in literature (%73.1). Median age at initial diagnosis was 27 years (range 20 to 38) and the male-to-female ratio was 12, respectively. Median follow up was 28.1 months (range 6 to 133). Multifocal bladder tumor was detected in 34 % of the patients under the age of 40 years while multifocality was encountered in % 14.3 under the age of 30 years. 3 of the patients (%11.5) had muscle invasive tumor. Ta tumor rate was % 92.9 in 20-30 year group and 1 except all T1 tumors and T2 tumors were diagnosed in the 30-40 years group. During follow up, one patient, who had T2 tumor died because of metastatic disease. Conclusion: TCC of the bladder can be seen rarely in young patients and it is usually superficial and low grade. Its recurrence and progression rate is lower. Therefore, TCC of bladder in young patients has a better prognosis.