Clinical and Pathological Features, and Cancer Behaviors of Non-Muscle Invasive Bladder Cancer

Abstract

Background and aims. Bladder cancer is the second most frequent genitourinary malignancy. Urothelial carcinoma makes up to 90 % of initial bladder tumors, and non-muscle invasive bladder cancer (NMIBC) makes the most common type of urothelial bladder cancer. Patients with NMIBC generally have an excellent prognosis, with a 5-year relative survival rate of 80–90%. Only 20 to 40 % of cases of bladder cancer manifest with or progress to muscle-invasive bladder cancer (MIBC). To determine the diagnosis and implement a strategic management plan for the disease, clinical and pathological assessments as well as cancer behavior of NMIBC are crucial. The aim of the present study was to determine the clinical and pathological features as well as cancer behaviors of NMIBC. Patients and Methods. A total of 32 NMIBC patients who were admitted to National Center Institution, Misurata, Libya between 2013 to 2017 were evaluated and followed up for at least 3 years. Results. Young and elderly NMIBC patients did not exhibit any appreciable differences in tumor behavior, prognosis, progression, or recurrence. In the examined instances with NMIBC, a statistically significant connection between smoking and hematuria was found (p- value < 0.015). A total of 23 samples of the NMIBC tissues (72%) were staged as T1, and 9 cases were staged as Ta (28 %). At the first transurethral re-section of the bladder tumor (TURBT), 19 patients (59%) were grade I, 11 patients (35%) were grade II, and 2 patients (6%) were grade III. Majority (29/32) of the cases received adjuvant intravesical chemo- or immuno-therapy therapy. In a minimum 3-year follow-up, only 6 cases (19%) experienced disease progression or recurrence. Conclusion. NMIBC had a good prognosis with TURBT and adjuvant intravesical chemo- or immune-therapy as recommended treatment strategies. High grade NMIBC requires specific management, demonstrating that early cystectomy as a possible disease treatment strategy.