Objective: Bladder urothelial carcinoma is a rare condition that primarily affects the elderly and is rare in people under 40 years of age. There is no definitive information about the prognosis and clinical behavior of bladder cancer in young individuals. In our study, we aimed to investigate the prognosis and clinicopathological features of bladder tumors in patients under 40.
Patients and methods: A retrospective analysis was performed on patients diagnosed with urothelial neoplasia who underwent bladder surgery between January 2008 and December 2020. The patient's medical records in our cancer database were collected. The study included stage, grade, multifocality, smoking habits, recurrence, and survival. The cases were divided into two groups: those under 40 (Group 1) and those over 40 (Group 2). The clinical and pathological features of young and old patients were compared.
Results: 17 patients (14 men and 3 women) under 40 were identified. The age ranged between 19 and 40, and the average was 30.6. One infiltrating urothelial carcinoma (pT1), twelve papillary urothelial carcinomas (pTa), two papillary urothelial neoplasias with low malignant potential, and two urothelial papillomas were all identified by pathology. Dysuria was the primary symptom that initially manifested. Recurrence occurred in two of 12 patients with low-grade papillary urothelial carcinoma in the young patient group. In a similar group of patients over 40, recurrence was detected in 7 out of 10 patients. Patients with urothelial carcinoma under the age of 40 have been noted to have single, small tumors, unlike older patients. No tumor progression was detected in young patients. All young patients are still alive and have not experienced any recurrences. In the group of older patients, tumor progression was observed in 11 patients (16.4%).
Conclusions: Patients under 40 typically have low-grade and low-stage bladder urothelial cancer. Because urothelial tumors in young people frequently have a good prognosis and seldom recur, transurethral excision is the preferred treatment method for bladder tumors.