Bladder cancer


The incidence of bladder cancer in the Russian Federation in 2006 was 12.4 (8th place in the structure of the incidence) in men and 1.8 in women per 100,000 population. The average age of patients is 67 and 69 years, respectively. In stages I-I, 57.4% were detected, in stage III – 26.8%, in stage IV – 11.4%, stage was not established in 4.5%, one-year mortality was 23.1%. Only surgical treatment was received by 45.2% of patients, combined or complex – 35.6%. Risk factors for the development of bladder cancer include work related to the production of aniline dyes, smoking, the use of drugs containing phenacetin, treatment with cytostatics from the cyclophosphamide group, chronic inflammation, exposure to ionizing radiation, urostasis, and schistosomatosis of the bladder. Bladder epithelial tumors make up 95%, of which 70-80% are transitional cell carcinoma, squamous and undifferentiated cancer, adenocarcinoma are less common. All changes in urothelium are divided into flat and papillary. Flat neoplasia is divided into reactive atypia, unclear clinical course, atypia with moderate dysplasia (low-grade uroepithelial neoplasia), in situ cancer (high-grade uroepithelial neoplasia). In papillary neoplasia, papilloma, inverted papilloma, papillary neoplasia with an undetermined potential for malignancy, papillary cancer of low and high malignancy are distinguished. In a separate group, invasive forms are distinguished – with invasion of the own plate of the mucous membrane, the muscle layer of the mucous membrane itself and the muscle layer of the bladder wall . Papilloma of the bladder macroscopically looks like a villous, well-vascularized tumor formation on a thin or wide stalk; there are single and multiple papillomas (papillomatosis). Bladder papilloma is an obligate precancer and requires surgical treatment with mandatory morphological examination of the removed tumor. Cancer in situ, an intraepithelial tumor with a low degree of differentiation, is distinguished by a special course. The tumor is more often localized in the region of the urinary bladder triangle, around the mouths of the ureters, in 50-70% of cases, multiple lesions are observed. The risk of tumor progression is from 40 to 80%.

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