Urothelial neoplasms in pediatric and young adult patients: A large single-center series Journal Article


Authors: Saltsman, J. A.; Malek, M. M.; Reuter, V. E.; Hammond, W. J.; Danzer, E.; Herr, H. W.; LaQuaglia, M. P.
Article Title: Urothelial neoplasms in pediatric and young adult patients: A large single-center series
Abstract: Purpose: Bladder cancer is the sixth most common cancer in the United States, but is exceedingly rare in young patients, leading to a lack of accepted standards for diagnosis, treatment, and surveillance. We review our institutional experience with bladder urothelial neoplasms in pediatric and young adult patients summarizing presentation, treatment, and outcomes. Methods: Surgical pathology records at our institution were searched for cases of urothelial neoplasms among patients ≤ 25 years of age treated between January 1997 and September 2016. Cases submitted exclusively for pathology review were excluded. Diagnoses were confirmed based on pathologic examination using the 2004 World Health Organization classification system. Results: Thirty-four patients were identified with a mean age of 21.1 years (range 8–25 years), and median follow-up was 25.1 months (1–187 months). The male to female ratio was 1.83:1. The most common presenting symptom was hematuria (n = 26; 76%). Diagnoses were invasive urothelial carcinoma (n = 3), noninvasive urothelial carcinoma (n = 24), PUNLMP (n = 6), and urothelial papilloma (n = 1). Noninvasive lesions were resected by cystoscopy, after which 12% (n = 4) experienced complications (grade II or greater). One patient with stage IV invasive disease at diagnosis died, and 2 patients developed recurrences. Of those with noninvasive carcinoma, 29% (n = 7) required repeat cystoscopy soon after initial TURBT at outside institutions, and 17% (n = 4) had tumors downgraded from high-grade to low-grade after pathology review. Conclusion: Hematuria is the most common sign of bladder neoplasia in children and young adults and should be investigated by cystoscopy. The majority of urothelial neoplasms in these patients are noninvasive and can be successfully treated with transurethral resection. Level of evidence: Level IV (Retrospective study with no comparison group). © 2017 Elsevier Inc.
Keywords: adolescent; adult; cancer chemotherapy; child; clinical article; human tissue; treatment outcome; young adult; cancer recurrence; interferon; cancer staging; follow up; cancer grading; laparotomy; bcg vaccine; cohort analysis; retrospective study; hematuria; pediatric; carcinoma in situ; cystectomy; urothelial carcinoma; recurrent disease; world health organization; invasive carcinoma; cystoscopy; papilloma; transurethral resection; mitomycin; transitional cell carcinoma; repeat procedure; urothelial neoplasms; human; male; female; priority journal; article; bladder neoplasia; urothelial papilloma
Journal Title: Journal of Pediatric Surgery
Volume: 53
Issue: 2
ISSN: 0022-3468
Publisher: W.B. Saunders Co-Elsevier Inc.  
Date Published: 2018-02-01
Start Page: 306
End Page: 309
Language: English
DOI: 10.1016/j.jpedsurg.2017.11.024
PROVIDER: scopus
PMCID: PMC5828877
PUBMED: 29221636
DOI/URL:
Notes: Article -- Export Date: 2 April 2018 -- Source: Scopus
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MSK Authors
  1. Victor Reuter
    1198 Reuter
  2. Harry W Herr
    586 Herr
  3. Marcus Malek
    2 Malek
  4. William Joseph Hammond
    13 Hammond
  5. Enrico Danzer
    13 Danzer