Singh Prashant, Sachan Ankit, Nayak Brusabhanu, Nayyar Rishi, Kumar Rajeev, Seth Amlesh
Department of Urology, National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India 110029.
Department of Urology, All India Institute of Medical Sciences, New Delhi, India 110029.
Indian J Surg Oncol. 2024 Sep;15(3):563-571. doi: 10.1007/s13193-024-01950-w. Epub 2024 May 10.
The evidence on bladder cancer in the young population remains fragmented due to lack of literature and conflicting results from the existing studies. We aim to elucidate such conflicting data and define the clinicopathologic characteristics, management trends, and outcomes of urothelial bladder carcinoma in young adults as compared to their older counterparts. This was a retrospective, single-center study involving patients with primary urothelial bladder cancer who underwent treatment at our center from March 2017 to March 2022. For analysis, patients were stratified into three subgroups based on age: group A, 18-40 years; group B, > 40 years; and group C, > 60 years. Group A with younger patients was compared with groups B and C. A total of 471 eligible patients (422 males and 49 females) were included in the study with a median age of 44 years. Group A had significantly lower recurrence and progression rates as compared to group B (31% vs 57.1%, = 0.002 and 9.5% vs 19.2%, = 0.04, respectively). Group A had significantly more recurrence-free survival (RFS) than group B (5-year-RFS = 68.03% vs 32.58%, = 0.01). Similarly, group A also had lower recurrence (31% vs 62.6%, < 0.001) and progression (9.5% vs 28.6%, = 0.015) rates as compared to group C as well as better RFS (5-year-RFS = 68.03% vs 19.00%, = 0.04) and progression-free survival (5-year-PFS = 83.1% vs 62.8%, = 0.03) in comparison to group C. Age and tumor grade were found to be independent predictors of recurrence-free and progression-free survival. We concluded that high-grade disease is more common than low-grade disease both in younger and older patients. Younger patients fare better in terms of recurrence and progression when compared to their older counterparts.
由于缺乏文献以及现有研究结果相互矛盾，关于年轻人群膀胱癌的证据仍然零散。我们旨在阐明这些相互矛盾的数据，并确定与老年患者相比，年轻成人尿路上皮膀胱癌的临床病理特征、治疗趋势和预后。这是一项回顾性单中心研究，纳入了2017年3月至2022年3月在我们中心接受治疗的原发性尿路上皮膀胱癌患者。为了进行分析，患者根据年龄分为三个亚组：A组，18 - 40岁；B组，>40岁；C组，>60岁。将较年轻患者的A组与B组和C组进行比较。该研究共纳入471例符合条件的患者（422例男性和49例女性），中位年龄为44岁。与B组相比，A组的复发率和进展率显著更低（分别为31%对57.1%，P = 0.002；9.5%对19.2%，P = 0.04）。A组的无复发生存期（RFS）显著长于B组（5年RFS = 68.03%对32.58%，P = 0.01）。同样，与C组相比，A组的复发率（31%对62.6%，P < 0.001）和进展率（9.5%对28.6%，P = 0.015）也更低，并且无复发生存期（5年RFS = 68.03%对19.00%，P = 0.04）和无进展生存期（5年PFS = 83.1%对62.8%，P = 0.03）更好。年龄和肿瘤分级被发现是无复发生存期和无进展生存期的独立预测因素。我们得出结论，无论是年轻患者还是老年患者，高级别疾病都比低级别疾病更常见。与老年患者相比，年轻患者在复发和进展方面表现更好。
