A Clinicopathological Study of Urinary Bladder Neoplasms in Patients at Three Centers in Khartoum, Sudan

Abstract

OBJECTIVES: To present the histopathological pattern of urinary bladder neoplasms using the WHO/ISUP classification system and relate it to the outcome.
METHODS: This study was conducted in the period from January 2004 through December 2005 at three centres in Khartoum, Sudan. One hundred and six patients with urinary bladder neoplasms were included in the study.
RESULTS: The commonest affected age group was 60-80 years with male to female ratio 4.6:1. Urothelial neoplasms were found in 72 (67.9%), Squamous cell carcinoma (SCC) in 26 (24.5%), urothelial neoplasms with Squamous differentiation in 3 (2.8%), and other types in 5 (4.7%) of the
patients. There were 43.4% of the urothelial neoplasms graded as papillary carcinoma of high grade, 52.6% papillary carcinoma of low grade, 1.3% papillary neoplasm of low malignant potential, 1.3% papilloma, and 1.3% was graded as flat neoplasm. Of the SCCs, twelve (42.9%)
were poorly differentiated SCCs, nine (32.1%) moderately differentiated, and seven (25%) cases were well differentiated SCCs. Follow-up information was available in 32 patients. At last followup, fifteen (46.9%) patients were dead of the disease, twelve (35.5%) were alive with no evidence of disease, four (12.5%) were alive with disease, and one (3.1%) was alive and terminally ill. CONCLUSION: Histological grade (P: 0.006), and muscle invasion (P: 0.002) were significantly associated with survival. A subset of the cases could not be assessed for muscle invasion due to
inadequate sampling; we thus recommend proper trans-urethral bladder biopsy (TUBP) sampling.

Key words: Urinary bladder neoplasm; Papillary carcinoma; Squamous cell carcinoma; WHO/ISUP classification system