Nonmuscular Invasive Urothelial Carcinoma of the Bladder in Pediatric and Young Adult Patients: Age-related Outcomes

Objective: To report 2 pediatric urology referral centers' experience on transitional cell carcinoma of the bladder (TCCB) in patients younger than 30 years, focusing on age-related prognostic factors. Materials and Methods: Patients younger than 30 years affected by TCCB from January 1999 to December 2011 were investigated. Spearman's rank test and Kruskal-Wallis test were adopted for statistical analysis. Results: Eighteen patients were identified (8 females, 10 males) and stratified by age at presentation: 5 in group A (12 years old and younger), 7 in group B (13-19 years), and 6 in group C (20-29 years). Females were predominant in groups A and B, whereas males were predominant in group C. Pathological grading revealed low-grade papillary urothelial carcinoma in 7, papillary urothelial neoplasm of low malignant potential in 7, and high-grade urothelial papillary carcinoma in 4 patients. At a mean follow-up of 6.5 years, recurrence was observed in 2 cases. Statistical analysis showed a positive correlation between age and grading. There was no statistical significance based on gender. Staging was significant between the age groups; older patients had more advanced tumors. Conclusion: TCCB is rarely observed in the first 3 decades of life. The prognosis is good in early-age presentation. Sex distribution, pathological grading, and prognosis were found different according to age. Patients younger than 19 years behave in a more favorable manner than those older, and should be followed up like adults.