Clinico-pathological Features of Squamous Cell Carcinoma of Urinary Bladder at South Egypt Cancer Institute (Retrospective Study)

Objectives: The objective of this research is to determine the 
clinicopathological characteristics of bladder squamous cell carcinoma 
encountered over a ten year period in Radiation Oncology Department, South 
Egypt Cancer Institute, Assiut University.
Methods: the medical records of bladder cancer cases during the period from 
2008 to 2018 were retrospectively reviewed and tabulated. 
Results: A total of 62 urinary bladder cancer (UBC) cases were recorded. The 
mean age was 57.21 ± 7.44 years (range; 40-70) years. The male-to-female ratio 
was 3.4:1. The main clinical presentation was burning micturition in 46.8%, 
followed by hematuria in 37.1%, dysuria in 9.7%, and cystitis in 6.5%. The 
ECOG performance status of the study cases was also assessed and showed that; 
85.5 % have PS Ⅰ, 11.3% have PS Ⅱ, and 3.2% have PS Ⅲ. Regarding tumor 
grade; almost all study cases (90.3%) have tumor grade Ⅱ, while 9.7% have 
tumor grade Ⅲ. Regarding tumor stage; 19.4%, 45.2%, 29.0%, and 6.5% had 
T1, T2, T3, and T4 respectively, and only one case suffered from positive nodal 
metastasis. Regarding treatment; 64.5% underwent radical cystectomy with 
uretero-cutaneous shunt, 22.6% underwent anterior pelvic excentration, 6.5% 
underwent partial cystectomy, and another 6.5% have bladder preservation. 
Patients who underwent radical cystectomy and partial cystectomy received 
neoadjuvant chemotherapy then underwent surgery and patients who underwent 
anterior pelvic excentration receive postoperative radiotherapy and patients 
refusing surgery underwent maximal TURBT then received concurrent 
chemoradiation. The median duration of follow up was 50 months (range; 5-171 
months). According to Kaplan-Meier analysis, at five year the rate of OS was 
79.2%. By the end of the study, 17.7% of patients had died of their cancer. A 
total of 6/62 patients (9.7%) developed disease recurrence. The median time to 
locoregional recurrence was 49 months (range, 4 to 171 months). According to 
Kaplan-Meier analysis, at five year the rate of DFS was 91.1%. There were 900 
cases of bladder cancer attending to South Egypt Cancer Institute in the period 
from the 1st of January 2008 up to the end of December 2018; 62 of these 
patients met the criteria in our study.
Conclusion: Bladder cancer is fairly common in our locality. SCC is generally, 
decreasing compared with TCC. This trend may be the outcome of improved 
bilharziasis control in rural Egyptian populations due to the use of potent oral 
antibilharzial medications.