Background:The urinary retention is recognized as a promoting factor for bladder cancer,but its role as prognostic factor of therapeutic response has not yet been widely considered.To correlate bladder outlet characte...Background:The urinary retention is recognized as a promoting factor for bladder cancer,but its role as prognostic factor of therapeutic response has not yet been widely considered.To correlate bladder outlet characteristics with short-term response to treatment in non-muscle-invasive bladder cancer.Materials and methods:We carried out a case-control study on 600 consecutive patients with a first diagnosis of non-muscle-invasive bladder cancer,recruited at the first endoscopic follow-up visit after standard treatment:200 patients were not tumor-free(cases)and 400 were tumor-free(controls).Patients were compared based on baseline and bladder-outlet characteristics("functional param-eters":postvoid residual volume[PVR],International Prostatic Symptoms Score,perceived quality of bladder outlet).t Test,x^(2)test,receiver operating characteristic curves,logistic correlations,and multivariate analysis were applied.Results:The cases had higher statistically significant PVR values compared with controls.We reported a linear correlation of no-tumor-free status with PVR(R^(2)=0.087,p<0.005);the receiver operating characteristic curves revealed an area under the curve of 0.824(95%confidence interval,0.783-0.865;optimal PVR cutoff,50 mL).In the multivariate analysis,age,American Society of Anesthesiologists score≥2,risk category≥intermediate,and all functional parameters represented independent factors for no-tumor-free status.Conclusions:Urinary retention could represent a prognostic factor of treatment response,and its active treatment should be considered as an important therapeutic step into the clinical management of bladder cancer patients.展开更多
文摘Background:The urinary retention is recognized as a promoting factor for bladder cancer,but its role as prognostic factor of therapeutic response has not yet been widely considered.To correlate bladder outlet characteristics with short-term response to treatment in non-muscle-invasive bladder cancer.Materials and methods:We carried out a case-control study on 600 consecutive patients with a first diagnosis of non-muscle-invasive bladder cancer,recruited at the first endoscopic follow-up visit after standard treatment:200 patients were not tumor-free(cases)and 400 were tumor-free(controls).Patients were compared based on baseline and bladder-outlet characteristics("functional param-eters":postvoid residual volume[PVR],International Prostatic Symptoms Score,perceived quality of bladder outlet).t Test,x^(2)test,receiver operating characteristic curves,logistic correlations,and multivariate analysis were applied.Results:The cases had higher statistically significant PVR values compared with controls.We reported a linear correlation of no-tumor-free status with PVR(R^(2)=0.087,p<0.005);the receiver operating characteristic curves revealed an area under the curve of 0.824(95%confidence interval,0.783-0.865;optimal PVR cutoff,50 mL).In the multivariate analysis,age,American Society of Anesthesiologists score≥2,risk category≥intermediate,and all functional parameters represented independent factors for no-tumor-free status.Conclusions:Urinary retention could represent a prognostic factor of treatment response,and its active treatment should be considered as an important therapeutic step into the clinical management of bladder cancer patients.
