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

Authors:

Umesh Jayarajah ,

National Hospital, LK
About Umesh
Department of Urology
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Hilary Fernando,

National Hospital, LK
About Hilary
Department of Urology
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Kasun Herath,

National Hospital, LK
About Kasun
Department of Urology
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Sanka Kuruppu,

National Hospital, LK
About Sanka
Department of Urology
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Uditha Wickramanayaka,

National Hospital, LK
About Uditha
Department of Urology
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Indika Fernando,

National Hospital, LK
About Indika
Department of Urology
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Chandu de Silva,

University of Colombo, LK
About Chandu
Department of Pathology
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Serozsha Goonewardena

National Hospital, LK
About Serozsha
Department of Urology
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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.

 

DOI: https://doi.org/10.4038/cmj.v65i4.9281
How to Cite: Jayarajah, U., Fernando, H., Herath, K., Kuruppu, S., Wickramanayaka, U., Fernando, I., de Silva, C. and Goonewardena, S., 2020. Clinicopathological patterns and outcomes of urothelial bladder malignancies in Sri Lankan patients. Ceylon Medical Journal, 65(4), pp.105–111. DOI: http://doi.org/10.4038/cmj.v65i4.9281
Published on 31 Dec 2020.
Peer Reviewed

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