Urothelial carcinoma in first histological diagnosis of patients over 80 years has distinctive histological features: a retrospective single-institution study of 185 patients.

Few histological data are known about patients with a first diagnosis of bladder cancer (BC) at the age ≥80 years. We describe the largest series in this patient group and their distinctive histological features. This unicentric retrospective study included patients at the age ≥80 years with a first diagnosis of bladder cancer between 2005 and 2015. All diagnosis was made by one senior uropathologist according to the WHO 2016 classification, pTNM 7th edition 2009. We examined samples of 185 patients, sex ratio M:W = 2.49:1, with ≥80 years at the time of first diagnosis of BC. The mean age was 85.1 years (84.8 for men and 85.8 for women). One hundred sixteen patients were diagnosed with NMIBC (non-muscle invasive bladder cancer) (62.7%). Sixty-nine patients were detected with MIBC (muscle invasive bladder cancer) (37.3%). In the MIBC, 20 (29.0%) cases, a divergent differentiation was reported. No patient had primary carcinoma in situ (Cis) at time of diagnosis, and concomitant Cis was observed in 18.9% (35 cases). According to our results, the histopathological findings are different from those of other patients' groups. The study shows a higher number of MIBC and a high percentage of histological variants. We could show distinctive pathological features in this patient group.