Urinary bladder cancer as a late sequela of traumatic spinal cord injury.
Battlefield injury
Medical assessment
Neurogenic bladder
Squamous cell carcinoma
Survival time
Transitional cell carcinoma
Traumatic spinal cord injury
Journal
Military Medical Research
ISSN: 2054-9369
Titre abrégé: Mil Med Res
Pays: England
ID NLM: 101643181
Informations de publication
Date de publication:
29 04 2021
29 04 2021
Historique:
received:
08
05
2020
accepted:
16
04
2021
entrez:
29
4
2021
pubmed:
30
4
2021
medline:
29
6
2021
Statut:
epublish
Résumé
Traumatic spinal cord injury (SCI) is also a combat-related injury that is increasing in modern warfare. The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge, and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI. A study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients. General patient information, latency period, age at initial diagnosis, type of bladder management and survival of SCI patients with bladder cancer were collected and analysed. T category, grading and tumour entity in these patients were compared with those in the general population. Relevant bladder cancer risk factors in SCI patients were analysed. Furthermore, relevant published literature was taken into consideration. Initial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years (SD ± 10.7 years), i.e., approximately 20 years earlier as compared with the general population. These bladder cancers are significantly more frequently muscle invasive (i.e., T category ≥ T2) and present a higher grade at initial diagnosis. Furthermore, SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis. Consequently, the survival time is extremely unfavourable. A very important finding, for practical reasons is that, in the Hamburg study as well as in the literature, urinary bladder cancer is more frequently observed after 10 years or more of SCI. Based on these findings, a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance. The results showed that urinary bladder cancer in SCI patients differs considerably from that in able-bodied patients. The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.
Sections du résumé
BACKGROUND
Traumatic spinal cord injury (SCI) is also a combat-related injury that is increasing in modern warfare. The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge, and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI.
METHODS
A study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients. General patient information, latency period, age at initial diagnosis, type of bladder management and survival of SCI patients with bladder cancer were collected and analysed. T category, grading and tumour entity in these patients were compared with those in the general population. Relevant bladder cancer risk factors in SCI patients were analysed. Furthermore, relevant published literature was taken into consideration.
RESULTS
Initial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years (SD ± 10.7 years), i.e., approximately 20 years earlier as compared with the general population. These bladder cancers are significantly more frequently muscle invasive (i.e., T category ≥ T2) and present a higher grade at initial diagnosis. Furthermore, SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis. Consequently, the survival time is extremely unfavourable. A very important finding, for practical reasons is that, in the Hamburg study as well as in the literature, urinary bladder cancer is more frequently observed after 10 years or more of SCI. Based on these findings, a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance.
CONCLUSIONS
The results showed that urinary bladder cancer in SCI patients differs considerably from that in able-bodied patients. The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.
Identifiants
pubmed: 33910625
doi: 10.1186/s40779-021-00322-7
pii: 10.1186/s40779-021-00322-7
pmc: PMC8082770
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
29Références
Urologe A. 2020 Jun;59(6):700-709
pubmed: 32020241
Arch Phys Med Rehabil. 2002 Mar;83(3):346-51
pubmed: 11887115
Spinal Cord. 2013 Jul;51(7):516-21
pubmed: 23608811
Eur Urol Focus. 2015 Aug;1(1):17-27
pubmed: 28723350
J Natl Cancer Inst. 1985 May;74(5):955-75
pubmed: 3858584
J Pediatr Urol. 2017 Oct;13(5):456.e1-456.e9
pubmed: 28687411
Int J Cancer. 2020 Apr 1;146(7):1930-1936
pubmed: 31863454
Spinal Cord. 2017 Apr;55(4):341-345
pubmed: 27824057
J Urol. 1996 Apr;155(4):1248-50
pubmed: 8632542
Spinal Cord. 2015 Mar;53(3):200-203
pubmed: 25403501
World J Urol. 2020 Nov;38(11):2827-2834
pubmed: 31932948
Cancer. 1997 Apr 15;79(8):1600-4
pubmed: 9118045
Int J Radiat Oncol Biol Phys. 2006 Nov 1;66(3):669-73
pubmed: 16887293
Mil Med Res. 2019 Feb 20;6(1):6
pubmed: 30786926
Can J Urol. 2018 Feb;25(1):9161-9167
pubmed: 29524970
Int J Cancer. 1995 Sep 27;63(1):1-6
pubmed: 7558434
J Urol. 2003 Nov;170(5):1734-7
pubmed: 14532765
Urology. 2002 Feb;59(2):240-4
pubmed: 11834395
IARC Monogr Eval Carcinog Risks Hum. 2004;83:1-1438
pubmed: 15285078
J Urol. 2000 Oct;164(4):1285-9
pubmed: 10992382
Curr Opin Urol. 2020 Jul;30(4):501-506
pubmed: 32427627
Br J Cancer. 1994 Jul;70(1):167-8
pubmed: 8018530
Int Urol Nephrol. 2017 Jun;49(6):983-994
pubmed: 28332134
Urology. 2007 Jan;69(1 Suppl):93-104
pubmed: 17280911
JAMA. 2011 Aug 17;306(7):737-45
pubmed: 21846855
Int J Cancer. 2019 Apr 15;144(8):1941-1953
pubmed: 30350310
J Urol. 1979 Aug;122(2):163-4
pubmed: 459006
Epidemiology. 2019 May;30(3):458-465
pubmed: 30601243
Int J Cancer. 2000 Apr 15;86(2):289-94
pubmed: 10738259
Cancer. 2006 Sep 1;107(5):991-8
pubmed: 16878323
J Urol. 2015 Jun;193(6):1923-8
pubmed: 25615534
Neurourol Urodyn. 2018 Apr;37(4):1386-1395
pubmed: 29168217
Medicine (Baltimore). 2015 Oct;94(43):e1736
pubmed: 26512566
J Natl Cancer Inst. 1995 Apr 5;87(7):524-30
pubmed: 7707439
J Spinal Cord Med. 1998 Jul;21(3):230-9
pubmed: 9863934
Am J Epidemiol. 1984 Apr;119(4):510-5
pubmed: 6711540
Urol Oncol. 2014 Jan;32(1):51.e1-7
pubmed: 24239459