Adverse pathological outcomes of patients with de novo muscle invasive bladder cancer in Northern Ontario
https://doi.org/10.4081/aiua.2022.1.41
Accepted: December 8, 2021
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Objective: This study aimed to investigate the clinical and pathological characteristics of patients with de novo muscle-invasive bladder cancer (MIBC) who underwent radical cystectomy in Northern Ontario.
Methods: This is a retrospective cross-sectional study of patients with de novo T2 MIBC who underwent radical cystectomy over a 2-year-period in Thunder Bay Regional Health Sciences Centre. Clinical and pathological characteristics of Trans Urethral Resection of Bladder Tumors and cystectomy specimens were analyzed.
Results: Of the 59 patients aged 67 ± 8.8 years, predominated by males (80%), 27.1% were younger than age 60. After surgery, upstaging was noted in 59.3% (T3 in 27.1% and T4 in 32.2%) while node positive was noted in 36% of patients. Prostate adenocarcinoma was incidentally discovered in 20 (34%) of patients with 50% considered significant (Gleason score ≥ 7). Downstaging was found in those who had neoadjuvant chemotherapy (p = 0.001).
Conclusions: The high prevalence of younger ages (less than 60), a high rate of upstaging, the presence of high-grade incidental prostate cancer, and lymph node positives in T2 de novo MIBC in Northern Ontario, warrants further investigation of potential causes and risk factors at individual, public, and population health levels in the region.
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68:394-424. DOI: https://doi.org/10.3322/caac.21492
Bachir BG, Kassouf W. Cause-effect? Understanding the risk factors associated with bladder cancer. Expert Rev Anticancer Ther.2012; 12:1499-1502. DOI: https://doi.org/10.1586/era.12.140
Delclos GL, Lerner SP. Occupational risk factors. Scand J Urol Nephrol. Suppl 2008; 218:58-63. DOI: https://doi.org/10.1080/03008880802284423
Maffezzini M, Fontana V, Pacchetti A, et al. Age above 70 years and Charlson Comorbidity Index higher than 3 are associated with reduced survival probabilities after radical cystectomy for bladder cancer. Data from a contemporary series of 334 consecutive patients. Arch Ital di Urol e Androl. 2021; 93:15-20. DOI: https://doi.org/10.4081/aiua.2021.1.15
Pless B. Health promotion and chronic disease prevention in Canada: Research, policy and practice. [updated 2021 February 4 , cited 2016 April 21. https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-41-no-2-2021.html. Accessed June 28,2021.
Siemiatycki J, Dewar R, Nadon L, et al. Occupational risk factors for bladder cancer: results from a case-control study in Montreal, Quebec, Canada. Am J Epidemiol. 1994; 140:1061-80. DOI: https://doi.org/10.1093/oxfordjournals.aje.a117207
Gaertner RRW, Trpeski L, Johnson KC. A case-control study of occupational risk factors for bladder cancer in Canada. Cancer Causes Control. 2004; 15:1007-19. DOI: https://doi.org/10.1007/s10552-004-1448-7
Villanueva CM, Fernández F, Malats N, et al. Meta-analysis of studies on individual consumption of chlorinated drinking water and bladder cancer. J Epidemiol Community Health. 2003; 57:166-73. DOI: https://doi.org/10.1136/jech.57.3.166
Villanueva CM, Cantor KP, King WD, et al. Total and specific fluid consumption as determinants of bladder cancer risk. Int J Cancer. 2006; 118:2040-47. DOI: https://doi.org/10.1002/ijc.21587
Wise S, Horn M, Geoffrey E. “Ontario.” Encyclopedia Britannica, October 29 2020. https://www.britannica.com/place/Ontarioprovince. Accessed May 19, 2021.
Ukwenya AY, Yusufu LMD, Nmadu PT, et al. Delayed treatment of symptomatic breast cancer: the experience from Kaduna, Nigeria. S Afr J Surg. 2008; 46:106-10.
Singh GK, Williams SD, Siahpush M, et al. Socioeconomic, ruralurban, and racial inequalities in US cancer mortality: Part I-All cancers and lung cancer and part II-Colorectal, prostate, breast, and cervical cancers. J Cancer Epidemiol. 2011; 2011:107497. DOI: https://doi.org/10.1155/2011/107497
Sruogis A, Ulys A, Smailyte G, et al. Incidentally found prostate cancer and influence on overall survival after radical cystoprostatectomy. Prostate Cancer 2012; 2012:1-5. DOI: https://doi.org/10.1155/2012/690210
Djaladat H, Bruins MH, Skinner EC, et al. Incidental prostate cancer in patients with radical cystectomy for bladder cancer. J Clin Oncol. 2013; 31:S225. DOI: https://doi.org/10.1200/jco.2013.31.6_suppl.225
Mazzucchelli R, Barbisan F, Scarpelli M, et al. Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant? Am J Clin Pathol. 2009; 131:279-83. DOI: https://doi.org/10.1309/AJCP4OCYZBAN9TJU
Hiros M, Selimovic M, Spahovic H, et al. Transrectal ultrasoundguided prostate biopsy, periprostatic local anesthesia and pain tolerance. Bosn J Basic Med Sci. 2010 Feb; 10:68-72. DOI: https://doi.org/10.17305/bjbms.2010.2740
DeGeorge KC, Holt HR, Hodges SC. Bladder cancer: diagnosis and treatment. Am Fam Physician. 2017; 96:507-14.
Nielsen ME, Palapattu GS, Karakiewicz PI, et al. A delay in radical cystectomy of >3 months is not associated with a worse clinical outcome. BJU Int. 2007; 100:1015-20. DOI: https://doi.org/10.1111/j.1464-410X.2007.07132.x
Ayres BE, Gillatt D, McPhail S, et al. A delay in radical cystectomy of >3 months is not associated with a worse clinical outcome. BJU Int. 2008; 102:10-45. DOI: https://doi.org/10.1111/j.1464-410X.2008.08084_1.x
Milowsky MI, Rumble RB, Booth CM, et al. Guideline on muscle invasive and metastatic bladder cancer (European Association of Urology Guideline): American society of clinical oncology clinical practice guideline endorsement. J Clin Oncol. 2016; 34:1945-52. DOI: https://doi.org/10.1200/JCO.2015.65.9797
Kulkarni GS, Black PC, Sridhar SS, et al. Canadian Urological Association guideline: Muscle-invasive bladder cancer. Can Urol Assoc J. 2019; 13:230-38. DOI: https://doi.org/10.5489/cuaj.5902
Porter MP, Kerrigan MC, Donato BMK, et al. Patterns of use of systemic chemotherapy for Medicare beneficiaries with urothelial bladder cancer. Urol Oncol. 2011; 29:252-58. DOI: https://doi.org/10.1016/j.urolonc.2009.03.021
Booth CM, Karim S, Brennan K, et al. Perioperative chemotherapy for bladder cancer in the general population: Are practice patterns finally changing? Urol Oncol. 2018; 36:89.e13-89.e20. DOI: https://doi.org/10.1016/j.urolonc.2017.11.015
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
