232 Clinical and pathological features of newly diagnosed bladder cancer in Spain

232

Clinical and pathological features of newly diagnosed bladder cancer in Spain Eur Urol Suppl 2013;12;e232

Miñana B.1, Cozar J.M.2, Palou J.3, Medina R.4, Subirá J.5, De La Rosa F.6, Chantada V.7, Lozano F.8, Ribal M.J.9, Spanish EPICAV Study Group, Madrid, Spain 1

Hospital Morales Meseguer, Dept. of Urology, Murcia, Spain, 2Hospital Virgen De Las Nieves, Dept. of Urology,

Granada, Spain, 3Fundacio Puigvert, Dept. of Urology, Barcelona, Spain, 4Hospital Virgen Del Rocío, Dept. of Urology, Sevilla, Spain, 5Hospital Clínico Lozano Blesa, Dept. of Urology, Zaragoza, Spain, 6Hospital Doce De Octubre, Dept. of Urology, Madrid, Spain, 7CHUAC, Dept. of Urology, La Coruña, Spain, 8Hospital Vall D'Hebrón, Dept. of Urology, Barcelona, Spain, 9Hospital Clinic, Dept. of Urology, Barcelona, Spain INTRODUCTION & OBJECTIVES: Bladder cancer (BC) is the second most common urological cancer. Its clinical and pathological characteristics not only possess prognostic value but also determine the therapeutic and follow-up approach. We present the clinical-pathological information obtained from the first national bladder cancer incidence study conducted in Spain in 2011. MATERIAL & METHODS: From January 1 to December 31, 2011, we carried out an epidemiological, observational study selecting 26 public centres with a known and stable covered population representing the different Spanish geographical regions, weighted by population. Each centre included all primary and recurrent bladder tumours with pathological confirmation. Demographic, anthropometric, clinical (diagnostic-related; treatment-related) and pathologic variables were collected from each patient. RESULTS: 4,285 cases of bladder cancer were diagnosed from a study reference population of 10.146.534 Â people (21,5% of the total Spanish population). 2,476 (58%) were primary and 1,809 (42%) were recurrent cases. Mean age at diagnosis was 70,5 years (SD: 11,4) with 81,7% being older than 60 years old. 2,084 (84%) were male and 389 (16%) female. Non muscle invasive BC (NMIBC) was detected in 76,7% of primary and 85,6% of recurrent cases (p<0,001). Mean tumour number was 1,8 cm in primary and 2,7 in recurrent group (p<0,001). A tumour size less than 3 cm occurred in 56,5% of primary and 78,4% of recurrent (p<0,001) with no differences observed regarding tumour location. 27% of the primary cases were of solid aspect compared with only 15,5% of recurrent tumours. Stage and grade characteristic are displayed in the following table: Primary Recurrent GRADE

X (unknown)

8,9%

17,9%

I

19,8%

24,8%

II

27,5%

29,7%

III

43,7%

27,7%

T STAGE

Tis

0,9%

3,2%

Ta

29,3%

39%

T1

42,3%

33,8%

T2

17,4%

10,3%

T3

3,3%

1,8%

T4

1,7%

1,5%

3,5%

4,9%

ISUP/WHO (2004) PUNLMP

HG carcinoma 51,1%

33,6%

LG Carcinoma 43,3%

55,7%

CIS

5,8%

2,2%

CONCLUSIONS: In Spain, most of primary NMIBC correspond to high risk patients but with a very low detected incidence of CIS. Recurrent tumours had lower size, grade and T stage, but more associated CIS probably revealing a higher concern of its presence in recurrent high risk patients.