Men have more than 4% chance of suffering from a Bladder Cancer over their lifetime and women about 1.2%. Incidence increases by age, and it means more than 100000 new cases in Europe annually, 30% of them Muscle-Invasive. In 2006, Bladder Cancer caused 4.1 and 1.8% of all deaths by Cancer in European men and women respectively, so prognosis evaluation is essential to optimize treatment in each patient.
There are some Pathological Risk Markers, among them, cell-line and histopathologic subtype, grade and tumour stage, and lymphatic, neural or vascular invasion.
Our purpose is to assess the relationship between Patients Age and these Risk Markers with Mortality.
Material and Methods.
We have performed an observational retrospective study, including patients undergoing Radical Cystectomy for Mucle-Invasive Tumour in San Cecilio Hospital, from January 2000 until December 2011. We collected data concerning Pathologic Characteristics of Surgical Specimens.
We studied 129 patients with Urothelial Carcinoma. Average age at Cystectomy was 66.69 years (range 35 to 85). Almost all tumours were classified as high grade, 73% of them had any histopathological differentiation, and 19% were Squamous. Carcinoma In Situ was observed in 7.1%, Vascular Invasion in 34.6%, Lymphatic Invasion in 21.4% and Perineural Invasion in 19.5%. About Growth Pattern, 9.3% was Papillary and 29.5% was Solid.
Splitting up sample in two groups (1 for patients untill 65 years old and 2 for patients over 65), we appreciated that Group 1 had higher incidence of Vascular Invasion without differences in other Markers. Mortality was similar in both groups and it was not influenced by having or not Vascular Invasion.
Among Group 1, patients with Squamous Cell Tumours had higher risk of cancer-specific mortality. In Group 2, Vascular Invasion is significantly associated with higher risk of mortality, as cancer-specific as global.
Patients aged 65 or younger have higher incidence of Vascular Invasion, despite that does not influence mortality. Opposite, among patients aged over 65 years old, Vascular Invasion is less common, but that is clearly related with mortality, as global, as cancer-specific. Other markers as Squamous differentiation in young patients and perineural involvement in elder also influence over cancer-specific mortality.
We have not found significant differences in most of items studied, but we think that it is possible to find new conclusions in a bigger stratified sample with higher statistical power.