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Objectives: to evaluate the clinicopathological features, recurrence and survival in patients up to 50 years of age diagnosed with primary bladder-cancer. Methods: during a 14-year period (1997-2011), 71 patients aged ≤50 years with bladder-cancer were analyzed in a single institution. Survival probabilities and associations were calculated using Kaplan-Meier, log-rank and Chi-squared-tests. Results: median age at diagnosis was 43.4 years (inter quartile-range [IQR] 39-47); median follow-up was 60.9 months (2.1-168.3). Non-muscle-invasive (NMI; pTa-pT1) bladder-cancer was commoner than muscle-invasive (MI; pT2-pT4) bladder-cancer (89% [n=63] versus 11% [n=8], respectively). Nineteen patients (27%) were ≤40 years and 52 (73%) were 41-50 years. MI bladder-cancer was commoner in 41-50-year group (13% [n=7/52]) than ≤40-year group (5% [n=1/19]; p=0.03), as was high-grade disease (23% [n=12/52] versus 16% [n=3/19], respectively; p=0.04). Twenty-one patients (30%) developed recurrence (29% [n=6/21] ≤40-years versus 72% [n=15/21] 41-50-years; p=0.12), with progression occurring only in 41-50-year group (19% [n=4/21]). A higher proportion of patients underwent cystectomy in the 41-50-year group (89% [n=8/9]) compared to those in the ≤40-year group (11% [n=1/9]; p=0.03). Five-year overall survival and cancer-specific survival were both 100% in ≤40-year group, and 84% and 86% in 41-50-year group, respectively. Among patients aged 41-50 years, those with MI bladder-cancer had particularly lower survival rates. Conclusion: bladder-cancer in younger adults is generally characterized by less aggressive disease with a favorable outcome. However, there is an increase in tumors incidence, muscle invasion, recurrence and progression after 40 years of age. Higher cystectomy and lower survival rates are also observed in this age group.

Clinicopathological Features and Therapeutic Outcomes of Bladder Cancer in Younger Adults