Clinicopathological characteristics and treatment patterns of bladder cancer in a tertiary oncology centre in Sub-Saharan Africa.

Abstract

167 Background: Bladder cancer is a significant urological malignancy with marked geographic variation in incidence, histopathology, and outcomes. In sub-Saharan Africa (SSA), data are limited, and patients frequently present with advanced disease. Methods: We conducted a retrospective analysis of patients with histologically confirmed bladder cancer managed at the Medserve-LUTH Cancer Centre, Lagos, Nigeria, between June 2019 and May 2024. Data were extracted from electronic medical records and included socio-demographic characteristics, clinical presentation, diagnostic modalities, and treatment received. Descriptive statistics were used for analysis. Results: A total of 102 patients were included. The mean age at presentation was 64.2 years (range: 40-87 years), and 61.8% were male. The most common presenting symptom was haematuria in 78 patients (76.5%), followed by dysuria in 24 patients (23.5%). A history of cigarette smoking and alcohol consumption was documented in 16.7% and 32.4% of patients, respectively. About 55.9% had at least one co-morbidity, mostly hypertension in 43 patients (42.2%), and diabetes in 13 patients (12.7%). Urothelial carcinoma was the predominant histological subtype (52%), followed by squamous cell carcinoma (10.8%) and adenocarcinoma (5.9%). At presentation, 26 patients (25.5%) had metastatic disease, with the most common sites being bone (10/26, 38.5%) and liver (6/26, 23.1%). Computed Tomography (CT) was performed in 65.7% of patients, while magnetic resonance imaging (MRI) was performed in 44.1%. Surgical intervention was performed in 50 patients (49%), with transurethral resection of bladder tumor (25, 50%), and cystectomy (6, 12%) being the most common procedures. Chemotherapy was administered to 40 patients (39.2%), primarily cisplatin (20, 50%), and gemcitabine (12, 30%). Out of the 102 patients, radiotherapy was delivered to 65 patients (63.7%), of whom 34 (52.3%) were treated with curative intent. Three-dimensional conformal radiotherapy was the most frequently used technique (61.5%), followed by intensity-modulated radiotherapy (35.4%). The bladder was the most commonly irradiated site (73.8%). Conclusions: This study provides real-world insights into bladder cancer management in a sub-Saharan African oncology centre. Urothelial carcinoma remains the predominant histological subtype, and management frequently involves multimodal therapy. Strengthening early detection, improving access to diagnostic imaging, and enhancing multidisciplinary oncology services are critical to improving outcomes in SSA.