Pediatric non-rhabdomyosarcoma bladder tumors (NRBTs): a 20-year retrospective longitudinal cohort study at a tertiary referral center.
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BACKGROUND: Pediatric non-rhabdomyosarcoma bladder tumors (NRBTs) encompass a diverse spectrum of tumors with low incidence rates. This study aims to improve understanding and contribute to the management of pediatric NRBTs. METHODS: We retrospectively enrolled patients with primary pediatric NRBTs diagnosed and treated at our center between 2003 and 2023. Clinicodemographic and clinicopathological data were collected. NRBTs were classified into four categories: urothelial tumors (UTs), mesenchymal tumors (MTs), neuroendocrine tumors (NTs), and rare types of bladder tumors (rBTs). Intergroup comparative analyses were conducted. RESULTS: We identified 51 cases of NRBTs. Four categories encompassed: UTs (n=25, 49.0%), MTs (n=17, 33.3%) and NTs (n=5, 9.8%), and rBTs (n=4, 7.8%). No cases of UTs were identified below the age of 3 years. Comparative analyses demonstrated significant intergroup differences in preoperative anemia prevalence (P=0.02) and tumor size (P<0.001). Total 45 patients (88.2%) completed follow-up, with a median duration of 64 months [interquartile range (IQR), 28-113 months]. Local recurrences were identified in 5 cases (11.1%), among whom 1 case (2.0%) succumbed to local recurrence and disease progression. CONCLUSIONS: Pediatric NRBTs demonstrate generally favorable clinical outcomes. Age under 3 years, preoperative anemia or a maximum tumor diameter exceeding 3 cm should raise a strong suspicion for non-UTs bladder tumors. Postoperative surveillance protocols can incorporate urinary ultrasonography (US) as a non-invasive monitoring tool.