Abstract：
BACKGROUND: Bladder cancer is highly prevalent even though its incidence is considerably lower in patients younger than 40 years, thus raising the issue of the influence of age at diagnosis on the natural history of this disease. This study aimed to evaluate the characteristics and progression of young patients with urothelial bladder carcinoma with at least 10 years of follow-up and to compare the results with those of previously reported studies.
METHODS: A retrospective study between 1990 and 2007 was conducted. The medical records and tissue samples of patients with urothelial bladder tumours were reviewed, and patients with a first diagnosis of urothelial carcinoma of the bladder at age 40 years or younger were selected. Their clinical and pathological data and disease-free survival were analysed.
RESULTS: This study included 43 patients, with a median follow-up of 152 months (interquartile range (IQR): 96-222) and a mean age at diagnosis of 34 years (SD: 4.6). Thirty-five patients (81.4%) had non-muscle invasive tumours at diagnosis, and 53.5%, 27.9% and 18.6% had tumour grades of G1, G2 and G3, respectively. Fifteen patients (34.9%) experienced recurrence, and eight (18.6%) progressed. At 24 and 60 months, the recurrence-free survival rates were 84.8% (95% confidence interval (CI): 69.2%-92.9%) and 68.9% (95% CI: 51.7%-81%), respectively, and the progression-free survival rates were 94.9% (95% CI: 81%-98.7%) and 92.2% (95% CI: 77.8%-97.4%), respectively.
CONCLUSIONS: Bladder cancer is an uncommon disease in young patients. In most cases, it consists of non-muscle-invasive tumours, with a low rate of recurrence and progression. The prognosis is based on the tumour\'s characteristics and not on the patient\'s age.
METHODS: A retrospective study between 1990 and 2007 was conducted. The medical records and tissue samples of patients with urothelial bladder tumours were reviewed, and patients with a first diagnosis of urothelial carcinoma of the bladder at age 40 years or younger were selected. Their clinical and pathological data and disease-free survival were analysed.
RESULTS: This study included 43 patients, with a median follow-up of 152 months (interquartile range (IQR): 96-222) and a mean age at diagnosis of 34 years (SD: 4.6). Thirty-five patients (81.4%) had non-muscle invasive tumours at diagnosis, and 53.5%, 27.9% and 18.6% had tumour grades of G1, G2 and G3, respectively. Fifteen patients (34.9%) experienced recurrence, and eight (18.6%) progressed. At 24 and 60 months, the recurrence-free survival rates were 84.8% (95% confidence interval (CI): 69.2%-92.9%) and 68.9% (95% CI: 51.7%-81%), respectively, and the progression-free survival rates were 94.9% (95% CI: 81%-98.7%) and 92.2% (95% CI: 77.8%-97.4%), respectively.
CONCLUSIONS: Bladder cancer is an uncommon disease in young patients. In most cases, it consists of non-muscle-invasive tumours, with a low rate of recurrence and progression. The prognosis is based on the tumour\'s characteristics and not on the patient\'s age.
摘要：
背景：膀胱癌非常普遍，尽管40岁以下患者的发病率相当低，因此提出了诊断年龄对这种疾病的自然史的影响的问题。这项研究旨在评估经过至少10年随访的年轻尿路上皮膀胱癌患者的特征和进展，并将结果与先前报道的研究进行比较。
方法：在1990年至2007年间进行了一项回顾性研究。回顾了膀胱尿路上皮肿瘤患者的医疗记录和组织样本，选择年龄在40岁或以下的首次诊断为膀胱尿路上皮癌的患者。分析患者的临床病理资料和无病生存期。
结果：本研究包括43名患者，中位随访时间为152个月（四分位距（IQR）：96-222），诊断平均年龄为34岁（SD：4.6）。35例患者（81.4%）在诊断时患有非肌肉浸润性肿瘤，53.5%,27.9%和18.6%的肿瘤分级分别为G1、G2和G3。15例患者（34.9%）复发，八人(18.6%)进步。在24个月和60个月时，无复发生存率分别为84.8%(95%置信区间(CI):69.2%-92.9%)和68.9%(95%CI:51.7%-81%),分别,无进展生存率分别为94.9%(95%CI:81%-98.7%)和92.2%(95%CI:77.8%-97.4%),分别。
结论：膀胱癌在年轻患者中是一种少见的疾病。在大多数情况下,它由非肌肉侵袭性肿瘤组成，复发和进展率低。预后是基于肿瘤的特征而不是患者的年龄。
方法：在1990年至2007年间进行了一项回顾性研究。回顾了膀胱尿路上皮肿瘤患者的医疗记录和组织样本，选择年龄在40岁或以下的首次诊断为膀胱尿路上皮癌的患者。分析患者的临床病理资料和无病生存期。
结果：本研究包括43名患者，中位随访时间为152个月（四分位距（IQR）：96-222），诊断平均年龄为34岁（SD：4.6）。35例患者（81.4%）在诊断时患有非肌肉浸润性肿瘤，53.5%,27.9%和18.6%的肿瘤分级分别为G1、G2和G3。15例患者（34.9%）复发，八人(18.6%)进步。在24个月和60个月时，无复发生存率分别为84.8%(95%置信区间(CI):69.2%-92.9%)和68.9%(95%CI:51.7%-81%),分别,无进展生存率分别为94.9%(95%CI:81%-98.7%)和92.2%(95%CI:77.8%-97.4%),分别。
结论：膀胱癌在年轻患者中是一种少见的疾病。在大多数情况下,它由非肌肉侵袭性肿瘤组成，复发和进展率低。预后是基于肿瘤的特征而不是患者的年龄。
