Shuck-Bello CE, Cantellano-Orozco M, Leos-Acosta CA, Andrade-Platas JD, Camarena-Reynoso HR, Vázquez-Ortega LS, Morales-Montor JG, Pacheco-Gahbler C, Mata-Miranda MP, Parraguirre S, Calderón-Ferro F

Language: Spanish
References: 6
Page: 268-272
PDF size: 132.90 Kb.

ABSTRACT

Introduction: Urothelial cancer is the fourth most common malignant tumor in Western men. It is 3 to 4 times more frequent in men having a mean age of 65 to 70 years. Fifty thousand new cases and 100,000 deaths are registered each year worldwide. In Mexico in 2000 the Malignant Neoplasia Histopathologic Register (NMHR) reported a death rate of 1.12 per 100,000 inhabitants.
Materials and methods: The case records of all our hospital patients who had presented with urothelial cancer from January 1990 to February 2007 were reviewed. Statistical analysis was carried out by means of central tendency, dispersion and Kaplan-Meier tables.
Results: A total of 110 patients was analyzed. Fifty men and 20 women fit the study criteria and their mean age was 60 years (range from 19 to 91 years). The most important risk factor was smoking, a factor in 50% of patients. Ninety-seven percent of patients presented with hematuria. Eighty-three percent of cases presented with bladder cancer and 17% presented with cancer in the upper urothelium. Of those cases, 63% were multicentric and 7% were associated with carcinoma in situ Thirty-three percent presented with stage Ta, 5% Tis, 36% T1, 13% T2, 7% T3 and 6% T4. Fifty-six percent of patients presented with high-grade tumor, 38% with low grade and 6% in situ. Transurethral resection of the bladder (TURB) was the principal treatment for 36% of patients followed by TURB + Bacillus Calmette-Guerin (BCG) in 18%. Mean recurrence was 46% at 17 months. Mean progression was 19.2% at 11.6 months. The best survival rate was in low-grade, non-multicentric tumors smaller than 2cm.
Conclusions: Greatest recurrence frequency was at 24 months and was associated with high-grade, multicentric tumors larger than 2 cm. There was a higher survival rate with mitomycin C treatment when compared with BCG.

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