Changing trend of transitional cell carcinoma of the bladder in Ile-Ife, South Western Nigeria

Abstract

Background: Recent studies from other parts of the world have reported a rising pattern of transitional cell carcinoma (TCC) amongst other histologic variants of bladder cancer. Objective: To report the changing trend of TCC in our practice at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria. Materials and methods: A retrospective review of clinical and pathological records of all bladder cancer cases managed between January 2006 and December 2015 in our hospital was done. Cases of TCC were identified, extracted and analyzed. Results: A total of 38 histologically confirmed bladder cancers were seen during the study period. TCC accounted for 61% (23), Squamous cell carcinoma 16% (6), Adenocarcinoma 13% (5), while secondary bladder tumor from prostate cancer accounted for 10% (4). Of the patients with TCC, mean age was 60 years ±13.4SD while the male to female ratio was 4:1. Ninety-five percent of them presented with hematuria. Risk factors identified in 57% of patients included smoking (43%) and industrial exposure to carcinogens (14%). Only 26% (6) of the TCC cases were non-muscle invasive while the remaining 74% (17) were muscle invasive. Eighty-seven percent (20) of the patients were treated while 13% (3) defaulted further treatment in our hospital after diagnosis. Among those treated in our centre, 30% (7) have had complete treatment with surgery and or chemotherapy and are presently on follow-up. Two patients (9%) have died, while 6 (26%) are still on treatment with intravesical chemotherapy. The remaining 8 patients (35%) have been lost to follow-up. Conclusion: TCC is rising in proportion amongst other types of bladder cancer. It is the commonest bladder cancer seen associated with cigarette smoking and industrial exposure to carcinogens.