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The association between postvoid residual and response to standard therapy in male and female patients with non–muscle-invasive bladder cancer
Ist Teil von
Current urology, 2023-12, Vol.17 (4), p.251-256
Ort / Verlag
Lippincott Williams & Wilkins
Erscheinungsjahr
2023
Link zum Volltext
Quelle
EZB Electronic Journals Library
Beschreibungen/Notizen
Abstract
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 parameters”: postvoid residual volume [PVR], International Prostatic Symptoms Score, perceived quality of bladder outlet).
t
Test,
χ
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.