Survival Analysis and Prognosis Factors of Urothelial Bladder Carcinoma in Moroccan Patient

Abstract

Introduction: Urothelial bladder carcinoma (UBC) is a major urological malignancy with heterogeneous clinical outcomes. Data on survival and prognostic factors in North African populations remain limited. This study aimed to evaluate overall survival and identify prognostic clinicopathological factors in a cohort of Moroccan patients with UBC.

Materials and Methods: We conducted a retrospective cohort study including 124 patients diagnosed with urothelial bladder carcinoma at Ibn Rochd University Hospital, Casablanca, between 2020 and 2022. Overall survival was estimated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors were assessed using univariate and multivariate Cox proportional hazards regression models. Median follow-up was estimated using the reverse Kaplan-Meier method.

Results: During a median follow-up of 28.14 months, 34 patients (27.4%) died. The median overall survival was not reached, and the estimated overall survival rate at last follow-up was 65.9% (95% CI: 57.47-74.52%). Patients with non-muscle-invasive bladder cancer (NMIBC) showed significantly better survival than those with muscle-invasive bladder cancer (MIBC) (log-rank p = 0.004). In univariate analysis, tumour stage, tumour grade, and histological subtype were significantly associated with overall survival. In multivariate Cox regression analysis, tumour stage remained the only independent prognostic factor. Compared with Tis/Ta tumours, patients with T2 disease (HR = 2.82, 95% CI: 1.35-5.89; p = 0.006) and T3 disease (HR = 6.39, 95% CI: 2.25-18.12; p < 0.001) had a significantly increased risk of death.

Conclusion: In this Moroccan cohort, tumour stage was the primary independent predictor of overall survival in urothelial bladder carcinoma. These findings highlight the critical importance of early diagnosis and accurate pathological staging and provide baseline survival data that may support future multicentre studies and improved risk stratification in the region.