A Clinico-Epidemiological Study and Clinical Outcome in Patients with Urinary Bladder Cancer at Assuit University Hospital from 2015-2019 (Hospital Based Study)

Abstract Background: Bladder Cancer is the third most common carcinoma after liver and breast in Egypt, the estimated incidence (7.9%) of all cancer new cases and occurs more commonly in developed countries. Aim of Study: To analyze the clinico-epidemiological characteristics of urinary bladder cancer, identifying factors associated with response, and prognostic factors for overall survival (OS) and disease-free survival (DFS). Patients and Methods: Ninety five patients with patho-logically confirmed bladder cancer (BC) presented to the Clinical Oncology Department, Assiut University Hospital during the period (2015 -2019) were retrospectively reviewed as regards patient's and tumor characteristics, risk factors, management, and pattern of failure. Results: The mean age was 61 years, with a male predom-inance in 77/95 (81%) of patients. Smoking was the main risk factor in 62/95 (65%) of patients, and the most common presenting complaint was hematuria in 84/95 (88%) of patients, followed by dysuria in 69/95 (73%) of patients. Transitional cell carcinoma was the most common pathology in 84/95 (88%) of patients, 93/95 (98%) of patients had invasive bladder cancer mainly high grade in 90/95 (95%) of patients. 31/95 (33%) of patients had Stage II followed by Stage III in 27/95 (28%) of patients, 19/95 (20%) of patients were Stage IVb, and 16/95 (17%) of patients were Stage IVa. Median DFS and OS are higher among patients <65, lateral wall of the bladder, low-grade tumor, the lower stage of the tumor, patients treated with radical cystectomy, responded to treatment, with no recurrence and no metastasis. The significant prognostic variables for DFS in a multi-variate cox logistic regression model were dome of bladder site (HR=3.7), anterior wall site (HR=3.8), non-responders to treatment (HR=6.5), and metastatic tumours (HR=4.4). In OS, the significant prognostic variablesalso were dome of bladder site (HR=3.0), anterior wall site (HR=3.3), non-responders to treatment (HR=2.7), and metastatic tumours (HR=5.2).
Conclusion: Epidemiology of bladder cancer was shifted in Egypt with higher incidence of TCC, Patients >!65, High-grade tumor, stage III, metastatic or recurrent, non-responded to treatment adversely affecting DFS and OS.