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Abstract：
BACKGROUND: A few studies regarding the epidemiology and risk factors of Non-muscle Invasive Bladder Cancer (NMIBC) are reported from Sub-Saharan African countries (SSA), including Somalia, and the African literature is scant on the management of NMIBC. The present study aims to evaluate the clinical-histopathological characteristics and factors associated with the survival rate of patients with NMIBC.
METHODS: This six-year cohort study included 196 patients with NMIBC. It reviewed the clinical and histopathological characteristics and factors predicting cancer-specific survival for these patients.
RESULTS: The mean patient age was 59.01 ± 11.50 years, with a male-to-female ratio of 2.8:1. Urothelial carcinoma (UC) constituted the most common pathological type, accounting for 90.8%; Ta LG and T1HG were the most common histopathological tumour stage and grade (n = 90, 45.9%, vs. n = 56, 28.6%), respectively. The mean tumour size was 4.72 ± 2.81 cm. The cancer-specific mortality(CSM) was 13.3%. Age [2.252(2.310-2.943], p < 0.001], Gender [1.031(0.981-1.1.242),p < 0.001], tumour stage and grade [4.902(3.607-5.614),p < 0.001], tumour location [1.135(0.806-1.172),p < 0.001], number [0.510(0.410-0.920),p = 0.03], tumour size [1.523(0.936-1.541),p < 0.001], use of intravesical chemotherapy or BCG [2.810(1.972-4.381),p < 0.001], preoperative hydronephrosis grade [1.517(1.172-2.154),p < 0.001], and follow-up compliance [3.376(2.633-5.018),p < 0.001] were all associated with CSM. The 5-year overall survival was 57.1%, and cardiovascular diseases were the leading cause of mortality (n = 34), followed by diabetes (n = 28).
CONCLUSIONS: Our study findings revealed that UC constituted the most common pathological subtype, though less than forty per cent of our patients receive intravesical adjuvant therapies, which are crucial to minimizing disease morbidity and mortality. Initiatives improving uro-oncological care, including subspecialty training in oncology and essential cancer therapies, better access to urology services, and cancer screening programs, are much needed for optimal management plans and care in the country.
METHODS: This six-year cohort study included 196 patients with NMIBC. It reviewed the clinical and histopathological characteristics and factors predicting cancer-specific survival for these patients.
RESULTS: The mean patient age was 59.01 ± 11.50 years, with a male-to-female ratio of 2.8:1. Urothelial carcinoma (UC) constituted the most common pathological type, accounting for 90.8%; Ta LG and T1HG were the most common histopathological tumour stage and grade (n = 90, 45.9%, vs. n = 56, 28.6%), respectively. The mean tumour size was 4.72 ± 2.81 cm. The cancer-specific mortality(CSM) was 13.3%. Age [2.252(2.310-2.943], p < 0.001], Gender [1.031(0.981-1.1.242),p < 0.001], tumour stage and grade [4.902(3.607-5.614),p < 0.001], tumour location [1.135(0.806-1.172),p < 0.001], number [0.510(0.410-0.920),p = 0.03], tumour size [1.523(0.936-1.541),p < 0.001], use of intravesical chemotherapy or BCG [2.810(1.972-4.381),p < 0.001], preoperative hydronephrosis grade [1.517(1.172-2.154),p < 0.001], and follow-up compliance [3.376(2.633-5.018),p < 0.001] were all associated with CSM. The 5-year overall survival was 57.1%, and cardiovascular diseases were the leading cause of mortality (n = 34), followed by diabetes (n = 28).
CONCLUSIONS: Our study findings revealed that UC constituted the most common pathological subtype, though less than forty per cent of our patients receive intravesical adjuvant therapies, which are crucial to minimizing disease morbidity and mortality. Initiatives improving uro-oncological care, including subspecialty training in oncology and essential cancer therapies, better access to urology services, and cancer screening programs, are much needed for optimal management plans and care in the country.
摘要：
背景：撒哈拉以南非洲国家（SSA）报道了一些关于非肌肉浸润性膀胱癌（NMIBC）的流行病学和危险因素的研究，包括索马里,非洲文献对NMIBC的管理知之甚少。本研究旨在评估NMIBC患者的临床组织病理学特征和与生存率相关的因素。
方法：这项为期6年的队列研究包括196例NMIBC患者。它回顾了这些患者的临床和组织病理学特征以及预测癌症特异性生存的因素。
结果：患者平均年龄为59.01±11.50岁，男女比例为2.8:1。尿路上皮癌(UC)是最常见的病理类型,占90.8%；TaLG和T1HG是最常见的组织病理学肿瘤分期和分级(n=90，45.9%，vs.n=56，28.6%)，分别。平均肿瘤大小为4.72±2.81cm。癌症特异性死亡率（CSM）为13.3%。年龄[2.252（2.310-2.943]，p<0.001],性别[1.031(0.981-1.1.242)，p<0.001],肿瘤分期和分级[4.902（3.607-5.614），p<0.001],肿瘤位置[1.135（0.806-1.172），p<0.001],编号[0.510(0.410-0.920)，p=0.03],肿瘤大小[1.523（0.936-1.541），p<0.001],使用膀胱内化疗或卡介苗[2.810（1.972-4.381），p<0.001],术前肾积水分级[1.517（1.172-2.154），p<0.001],和后续合规性[3.376(2.633-5.018)，p<0.001]均与CSM相关。5年总生存率为57.1%,心血管疾病是死亡的主要原因(n=34)，其次是糖尿病（n=28）。
结论：我们的研究结果表明，UC是最常见的病理亚型，尽管只有不到40%的患者接受膀胱内辅助治疗,这对降低疾病发病率和死亡率至关重要。改善肿瘤护理的举措，包括肿瘤学和基本癌症治疗的亚专科培训，更好地获得泌尿外科服务，和癌症筛查计划，在这个国家非常需要优化的管理计划和护理。
方法：这项为期6年的队列研究包括196例NMIBC患者。它回顾了这些患者的临床和组织病理学特征以及预测癌症特异性生存的因素。
结果：患者平均年龄为59.01±11.50岁，男女比例为2.8:1。尿路上皮癌(UC)是最常见的病理类型,占90.8%；TaLG和T1HG是最常见的组织病理学肿瘤分期和分级(n=90，45.9%，vs.n=56，28.6%)，分别。平均肿瘤大小为4.72±2.81cm。癌症特异性死亡率（CSM）为13.3%。年龄[2.252（2.310-2.943]，p<0.001],性别[1.031(0.981-1.1.242)，p<0.001],肿瘤分期和分级[4.902（3.607-5.614），p<0.001],肿瘤位置[1.135（0.806-1.172），p<0.001],编号[0.510(0.410-0.920)，p=0.03],肿瘤大小[1.523（0.936-1.541），p<0.001],使用膀胱内化疗或卡介苗[2.810（1.972-4.381），p<0.001],术前肾积水分级[1.517（1.172-2.154），p<0.001],和后续合规性[3.376(2.633-5.018)，p<0.001]均与CSM相关。5年总生存率为57.1%,心血管疾病是死亡的主要原因(n=34)，其次是糖尿病（n=28）。
结论：我们的研究结果表明，UC是最常见的病理亚型，尽管只有不到40%的患者接受膀胱内辅助治疗,这对降低疾病发病率和死亡率至关重要。改善肿瘤护理的举措，包括肿瘤学和基本癌症治疗的亚专科培训，更好地获得泌尿外科服务，和癌症筛查计划，在这个国家非常需要优化的管理计划和护理。
