Surgical Treatment Results of Invasive Non-Transitional Cell Tumours of the Bladder

Although the majority of bladder cancers are transitional cell carcinomas (TCC), non-transitional cell tumours (non-TCT) have significant importance because of their aggressive clinical course. We evaluated the treatment results of invasive transitional and non-transitional bladder tumours treated in our department. Non-transitional cell tumours were demonstrated in 51 (9.6%) of 527 bladder cancer cases from 1992 to 1998 in our department. Radical cystectomy was performed in 177 invasive bladder cancer patients and of these 47 (26.5%) had non-transitional cell tumours. The majority of patients (92.15%) with non-transitional cell tumours of the bladder had invasive disease at the time of diagnosis. The distribution of non-transitional cell tumours was: 24 (51%) squamous cell carcinoma (SCC), 15 (31.7%) undifferentiated carcinoma (UC), 4 (8.5%) adenocarcinoma and 4 (8.5%) sarcoma. Overall 12 and 42 months disease specific survival rates for TCC patients were 69.37% and 47.22%, respectively, whereas overall 12 months survival rate for non-TCT patients was 47.61%. The survival rates after radical cystectomy for SCC, UC, adenocarcinoma and sarcoma were 35.8%, 41.5%, 37.5% and 75%, respectively. In the literature, the incidence of non-transitional tumours is 5%. However, in our department, we observed an incidence of 26.5% between 1992 and 1998. We also arrived at the conclusion that non-transitional tumours of the bladder tend to be more aggressive than invasive urothelial tumours and in most patients invasive disease was also present at the time of diagnosis. Early diagnosis and radical cystectomy are the most important factors that influence the survival in cases of invasive non-transitional cell tumours of the bladder.