Oncological Outcomes of Non-Muscle Invasive Bladder Cancer in Patients Aged ≤45: A Retrospective Matched Cohort Study.

Authors

Marie-Pier St-Laurent, Shayan Din, Joseph Moryousef, Katherine Lajkosz, Jethro C C Kwong, Amy Chan, Jaehoon Kim, Afton Taborek, Avesh Chadee, Iman Sadri, Gabrielle Reznik, Caris Tin, Neil E Fleshner, Girish S Kulkarni, Peter C Black, Wassim Kassouf, Alexandre R Zlotta

Published in

The Journal of urology. Pages 101097JU0000000000005183. Jun 24, 2026. Epub Jun 24, 2026.

Abstract

The majority of bladder cancers are diagnosed as non-muscle invasive (NMIBC), with 90% over the age of 55. Although the incidence of several malignancies is increasing among younger adults in whom more aggressive behavior is observed, our knowledge about NMIBC in young patients remains limited. We compared oncologic outcomes in NMIBC patients ≤45 years old to a cohort of older patients.
Retrospective study of NMIBC diagnosed at age ≤45 (2005-2022) from four Canadian centers. Endpoints included cancer-specific mortality (CSM), risk of metastasis, progression to muscle invasion, NMIBC progression (eg. Ta/CIS to T1), grade progression and recurrence. Competing risk analysis and Kaplan-Meier estimates were used. Hazard ratios were calculated using Fine and Gray regression. Propensity score matching (3:1) was used with patients aged >45. Scores were estimated using a logistic regression model incorporating sex, carcinoma in situ (CIS), stage, grade, tumor size, number and year of TURBT.
Among 158 patients, median age was 39 years (IQR 32-42) and median follow-up 6.0 years (IQR 2.9-9.8). The majority were male (66%), with solitary (78%), low-grade (64%), Ta (82%) tumors. After 3:1 matching, 124 younger patients were compared to 350 older patients (median age 76 years, IQR 69-82). Recurrence rates were higher in older patients (HR 1.53, 95% CI 1.09-2.14, p=0.013). CSM, grade progression, and progression to muscle invasion or metastases were not significantly different (all p>0.05) between groups.
NMIBC exhibits similar behavior in patients younger than 45 compared to older patients but with a lower recurrence rate.

PMID:
42341207
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

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