Clinicopathological patterns and outcomes of urothelial bladder malignancies in Sri Lankan patients.

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL Ceylon Medical Journal Pub Date : 2020-12-31 DOI:10.4038/cmj.v65i4.9281
Umesh Jayarajah, Hilary Fernando, Kasun Herath, Sanka Kuruppu, Uditha Wickramanayaka, Indika Fernando, Chandu De Silva, Serozsha Goonewardena
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引用次数: 1

Abstract

Introduction: Studies on bladder cancer in Sri Lanka have shown varying results in relation to clinicopathological characteristics and data on outcomes is limited. This study was aimed to describe the clinicopathological characteristics and outcomes of histologically confirmed urothelial bladder malignancies and to compare with previous studies.

Methods: A retrospective analysis of prospectively collected data of 314 newly diagnosed primary bladder malignancies between January-2007 and January-2017, was performed. After excluding the non-urothelial cancers, 289(92%) urothelial cancers (males=245, 84.8%, mean age = 65.4±SD10.9 years) were analysed. Data on clinical presentation, cystoscopic findings, histopathology and outcomes were studied.

Results: The majority (87.9%, n=254) presented with haematuria with a median duration of symptoms of 1 month. Non-muscle invasive cancers were seen among 64.4% (pTa:n=87(30.1%),pT1:n=99(34.3%)). The pT1 high grade (pT1-HG) tumours were seen in 17.5%. Muscle invasive bladder cancer (MIBC) were seen in 35.6%(n=103). The majority were high grade tumours (n=156,54%). Urothelial MIBC were significantly associated with solid tumours (p<0.001), high grade (p<0.001) and size>3cm (p<0.001). Comparison with previous studies showed a decline in the proportion of MIBC while the pT1-HG tumours are on the rise. Of those followed up, 52.5% developed recurrences with a median duration of 4 months (interquartile range (IQR): 3-12 months). Eighteen (9%) progressed to a higher stage with a median duration of 17 months (IQR:3.75-41.75).

Conclusions: Urothelial cancer in the study population was 92%. Higher proportion of MIBC, high grade tumours and pT1-HG tumours were noted. The recurrence rate was high. Future studies should focus on the causative factors for this trend.

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斯里兰卡患者尿路上皮膀胱恶性肿瘤的临床病理模式和结果。
导言:斯里兰卡膀胱癌的研究显示了与临床病理特征相关的不同结果,结果数据有限。本研究旨在描述经组织学证实的尿路上皮性膀胱恶性肿瘤的临床病理特征和预后,并与以往的研究进行比较。方法:回顾性分析2007年1月至2017年1月期间前瞻性收集的314例新诊断的原发性膀胱恶性肿瘤的资料。排除非尿路上皮癌后,共分析289例(92%)尿路上皮癌(男性245例,84.8%,平均年龄65.4±SD10.9岁)。研究了临床表现、膀胱镜检查结果、组织病理学和结果。结果:大多数患者(87.9%,n=254)表现为血尿,症状持续时间中位数为1个月。非肌肉浸润性癌占64.4% (pTa:n=87(30.1%),pT1:n=99(34.3%))。pT1高分级(pT1- hg)肿瘤占17.5%。肌肉浸润性膀胱癌(MIBC)占35.6%(n=103)。多数为高级别肿瘤(n=156,54%)。尿路上皮MIBC与实体瘤(p3cm)显著相关。结论:研究人群中尿路上皮癌发生率为92%。mbc、高分级肿瘤和pT1-HG肿瘤的比例较高。复发率高。未来的研究应关注这一趋势的致病因素。
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Ceylon Medical Journal
Ceylon Medical Journal MEDICINE, GENERAL & INTERNAL-
自引率
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发文量
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期刊介绍: The Ceylon Medical Journal, is the oldest surviving medical journal in Australasia. It is the only medical journal in Sri Lanka that is listed in the Index Medicus. The CMJ started life way back in 1887 as the organ of the Ceylon Branch of the British Medical Association. Except for a brief period between 1893 and 1904 when it ceased publication, the CMJ or its forbear, the Journal of the Ceylon Branch of the British Medical Association, has been published without interruption up to now. The journal"s name changed to the CMJ in 1954.
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