Clinicopathological Spectrum of Urothelial Carcinoma – A Study from Tertiary Care Set Up

Background: Urothelial carcinoma is the most common malignancy encountered in genitourinary tract. Urinary bladder cancer is the 7th most common malignant tumor worldwide. It is a disease of older age group. Objective: To determine the demographic characteristics of urinary bladder cancer and to analyze the cases of urothelial carcinoma according to gender, age, grade, invasion, histologic subtype, presenting complaints and pathologic stage of specimens. Study Design: Retrospective study. Settings: Pathology Department of Faisalabad Medical University from Department of Urology of Allied Hospital Faisalabad Pakistan. Duration: Three years (January 2015-December 2018). Methodology: Total 305 cases were included in this study. Results: 226 were male patients (74%), and 79 (26%) were females.  Majority of the patients (62%) with urothelial carcinoma in this study were in their 5th and 6th decade of their life. Only 27 patients (8.8%) were below 40 years. Of total cases 149(48%) were of low grade, 150(49%) were of high grade and only 6 cases (2%) fell under the category of lesion named PUNLMP. 151(49%) cases were detrusor muscle invasive and 151(49%) were non-invasive and only 3 (1%) cases were found in which no muscle biopsy was identified. 99% of patients were diagnosed with commonest type of tumor that is transitional cell carcinoma, while only 3 (1%) cases were of transitional cell carcinoma with squamous differentiation. Painless visible hematuria was the most common presenting complaint (96%) followed by dysuria (3%) and storage symptoms (1%). Majority patients lie under the pathologic stage pT1(50%) then in pT2(48%). A significant co-relation was found between gender and a grade of tumor. Female patients (60%) presented with higher grade and aggressive disease. Patients of younger age group (below 40) were diagnosed with low grade carcinoma. Conclusion: Urothelial carcinoma is a disease of elderly people with a significant predominance of male patients. Painless hematuria is the most common presenting symptom.