Epidemiological, Therapeutic and Evolutive Aspects of Bladder Cancer in Douala

Author(s): Jean Paul Engbang, Hervé Moby, Falonne Daoudou Soumaï, Boris Amougou, Makon Nwaha, Marcelin Ngowe Ngowe

Bladder cancer can be defined as the uncontrolled proliferation of bladder cells, leading to the formation of a heterogeneous lesion. These bladder cells have variable sizes with no clear boundaries and potential to invade or spread to other parts of the body. This pathology is ranked second among genito-urinary cancers after prostate cancer. Our goal is to study the epidemiological, therapeutic and evolution aspects of bladder cancer in three hospitals in the city of Douala.

Methodology: We carried out a descriptive study on the medical files of the patients during a period of 10 years, from January 1st 2011 to December 31st 2020. We retrieved medical reports of patients with bladder cancer in three hospitals in the city of Douala and included medical reports that provided information on age, sex, patient’s or guardian’s phone number and the pathology results. Our results were analyzed using SPPS 25.0 software.

Results: We included a total of 122 medical reports in our study. There were 74 men and 48 women. The mean age was 58.0±13.3 years with extremes between 24 years and 91 years. The most affected professions were housewives and farmers with 34 cases (27.8%) and 27 cases (22.1%) respectively. The mean consultation period of patients to the urologist was 2.2 months. The most frequent symptom reported by patients was macroscopic hematuria in 80 cases (65.6%). Past medical history of active smokers was the most frequent in 36 patients (29.5 %), followed by recurrent urinary tract infection. At the histology level, urothelial carcinoma was the most common finding with 60 cases (49.2%). Medical and surgical treatment was established according to the tumoral stage. In stage II, transurethral resection associated with local chemotherapy after surgery was performed in 69 patients (66.3%). In stages III and IV, 66.6 % and 22.2% patients benefited from partial or total cystectomy, without pre-operative chemotherapy respectively. The Methotrexate-Vinblastine-Doxorubicin-Cisplatine protocol was the most used especially in stage III in 50.0 % cases. Early post-operatory was complicated in 12.8% cases. The mean survival rate was 59.6 months with a CI= [42.622-75.378] and global survival rates at one year, three and five years were 85.2%, 41.0% and 12.3% respectively.

Conclusion: transurethral resection of the bladder, chemotherapy coupled with radical surgery play an important role in the treatment of bladder cancer. The global survival rates would be greatly improved if the availability and harmonization of treatment modalities were at the center of patient management. Also, studies on prognostic factors would facilitate a better identification of factors associated to the survival of patients with bladder cancer.