Presented Tuesday, 04 September 2007 at the 29th Congress of the Societe International d'Urologie - SIU 2007 - Optimizing Clinical Outcomes in Prostate and Renal Cell Carcinomas - The Second Annual Symposium on Advanced GU Malignancy - Palais des Congres de Paris, France

Introduction: Squamous cell carcinoma (SCC) in the non-bilharzial bladder is uncommon. We reviewed the peculiarity in our region of this tumor in terms of epidemiological, diagnosis, surgical treatment and outcome.

Methods: From December 1982 to January 2006, a total of 51 cases of SCC of the bladder unrelated to schistosomiasis were observed in our department of urology.

Results: The mean age for the patients was 60 years. Male to female ratio: 3, 6. Mean consultation delay was 6 months. Smoking intoxication was found in 29 cases (56%). Recurrent urinary infection was seen in 9 cases without history of schistosomiasis (17%). Irritative bladder symptoms are the main clinical presentation (94%). Hematuria was seen in 80% of patients. A recurrent urinary tract infection was present in 17% of patients. Bladder stones were observed in 8 cases (15%). Two-thirds of patients have a large, solid and solitary tumor witch involves the bladder wall. Imaging demonstrated hydronephrosis in 60 % of cases. At the time of diagnosis 76% of the tumors were at T3 and T4 stages and histologic examination showed a high grade in 66%, 2 of theme were verrucous carcinoma. Radical cystectomy was performed in 22 patients. The remaining received a palliative treatment. Two cases presented early recurrence after cystectomy. No distant metastases were observed. The survival rate was 70% at 1 year and 10% at 10 years.

Conclusion: Non-bilharzial bladder carcinoma is a distinct clinicopathologic entity. It has a poor prognosis, often related to locoregional failure not to metastasis. This tumor is also generally insensitive to standard chemotherapeutic regimens used against urothelial cancer, leaving few treatment options.

Authors: Chaaben W, Sahnoun A, Bouacida M, Bahcine T, Fakhfekh H, Bahloul A, Mhiri MN

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