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Histoprognostic Factors in Bladder Cancer: A Case Series of 156 Patients

Benhayoune K*, Tahiri L1, Mellas S, Tazi F2, Khallouk A, El-Fassi J, Farih MH and El-Fatemi H

Introduction: Bladder cancer is the second most common cancer of the genitourinary tract. The transitional cell carcinoma accounts for nearly 90% of all primary tumors of the bladder. Although the majority of patients have superficial tumors, 20% or 40% have invasive disease develops. The pathologist plays a crucial role in determining the histological type, as well as determining factors for a histoprognostic proper care of patients.

Objectives: The purpose of this study is to provide an epidemiological overview of bladder cancer and to find an association between tumor grade and other histoprognostic factors.

Materials and Methods: We conducted a retrospective study of 156 bladder tumor listed in the laboratory of pathology of CHU Hassan II Fez over a period of 6 years from 2009 to 2014.

Results: Median age was 62 years with a sex ratio M/F=8.7. Transitional cell carcinoma (TCC) was the most common histological type (87.8%). 36.8% of TCC were classified as low grade and 63.2% in high grade according to WHO in 2004. The tumor was superficial in 23.7%. It has been classified as pT1 in 22.4%, 36.2% in pT2, pT3 in 9.9% and 7.2% in pT4. In this series, 64.4% of patients over age 50 had high-grade tumors compared with 45% of patients younger than 50 years (p=0.08). We found a significant association between sex and grade of the tumor. In fact, 85.7% of women had a high-grade tumor (p=0.05). 85.6% of TCC were in localized stage, compared to 58% in other histological types (p=0.01). This study showed a significant association between the grade and stage of the tumor (p=0.006). It was also noted a significant association between tumor grade and the presence of vascular emboli (p=0.002).

Conclusion: In conclusion, the presence of a high-grade tumor is strongly associated with factors of poor prognosis, such as advanced tumor stage and vascular emboli. Urothelial tumors of the bladder are far more common in men than in women buthey are more aggressive in women than in men.