Evaluation of the stage and grade of bladder cancer diagnosed for the first time in patients attending Almouwasat University Hospital

Abstract

Introduction: Bladder cancer is the second most common urogenital tumor. The stage, grade, number and diameter of urinary bladder cancer is an important factors in determining prognosis of the disease. Early diagnosis and proper treatment are also critical to improve survival.

Objectives: This retrospective study was performed to determine the clinical, stage, and grade of primary bladder cancer at first presentation at Almouwasat University hospital.

Patients and Methods: From Jan 2018 to June 2022, we retrospectively evaluated 192 patients with primary bladder cancer. All patients were evaluated with regards to clinical presentation, cystoscopic findings and histo-pathological data.

Results: Our study population (192 patients) comprised 16.7 % females and 83.3% males. The median age was 62 years (range:38–72), 146 patients (76%)  had history of cigarette smoking. Most patients (86.4%) presented with painless hematuria. Primary transitional cell carcinoma was the most common (i.e. 94.8%) histological variety of bladder carcinoma. We found that 23.4% of patients had (Ta) cancer, 48.4% had tumor with subepithelial connective tissue invasion (T1), 28.2% of patients had muscle invasive tumors (≥T2) and 6.3% were associated with (CIS) at the time of presentation. Regional or distant metastases were found in 6.3% of patients. Well differentiated tumor (LG) was seen in 35.4% of the patients and poorly differentiated tumor (HG) was found in 39.6% of the patients.

Conclusion: Most bladder tumours in our study are urothelial carcinomas, and majority of them are in T1 stage and HG. They are more common in men than in women and the incidence increases with age. Macroscopic hematuria is the most common symptom. Awareness is needed among the public and treating physicians as they tend to neglect the symptoms of hematuria, resulting in an advanced stage of bladder cancer at presentation. And the situation can be further improved by the awareness about smoking risks, adopting proper screening programs and performing appropriate investigations.