SINGLE CENTER AUDIT OF URINARY BLADDER MALIGNANCY: A 3-YEAR RETROSPECTIVE ANALYSIS OF HOSPITAL DATA

Manjunath T.*, Puskal Kumar Bagchi, Mandeep Phukan, Debanga Sarma, Rajeev T. P. and Sasanka Kumar Barua

ABSTRACT

Introduction: Urinary Bladder cancer (BC) is one of the most common urological malignancies. It accounts for a large case load in uro- oncology. As per the Indian cancer registry, bladder cancer constitutes the ninth most common malignancy and accounts for an overall 3.9% of all cancer cases. 70% to 85% have non–muscle-invasive bladder cancer (NMIBC) and 15% to 30% have muscle-invasive bladder cancer (MIBC). Transurethral resection is primarily employed treatment for NMIBC, whilst radical surgery either with neoadjuvant chemotherapy or adjuvant chemotherapy is used to treat MIBC. Clinical auditing is essential as it exposes the deficient areas of management. Methods: Cancer registry of the last 3 years at Dept. of Urology and Renal Transplant Gauhati Medical College Hospital was searched for demographic, clinical, pathological and prognostic data and results summarized using statistical parameters of univariate analysis. Results: There were a total of 97 patients in the NMIBC group with a majority in the 60-70- year age group. The most common grade was G2. Smoking was a constant phenomenon in all patients of NMIBC (n=97) and MIBC (n=40) population. Positive urine cytology was significantly associated with the MIBC population. Conclusions: Although TURBT is a standard of care for NMIBC, single modality treatment is not sufficient and high-grade tumors are dealt in aggressive manner and though induction and maintenance BCG immunotherapy deters progression and recurrence, it did not confer total immunity against the disease. Even radical cystoprostatectomy with pelvic lymphadenectomy / pelvic exenteration is the gold standard treatment for muscle-invasive urinary bladder cancer; some patients succumb to postoperative comorbidities.

Keywords: irritative voiding, neoadjuvant chemotherapy, radical cystectomy, transurethral resection of bladder tumor.