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A Journal on Nephrology and Urology

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Minerva Urologica e Nefrologica 2017 Dec 14

DOI: 10.23736/S0393-2249.17.02992-7


language: English

A larger detrusor wall thickness increases the risk of non muscle invasive bladder cancer recurrence and progression: result from a multicenter observational study

Antonio CICIONE 1 , Stefano MANNO 2, Giuseppe UCCIERO 2, Francesco CANTIELLO 2, Rocco DAMIANO 2, Estevao LIMA 3, Alessandro POSTI 1, Filippo BALLONI 1, Cosimo DE NUNZIO 4

1 Città di Castello Hospital, Urology Department, ASL Umbria 1, Città di Castello, Perugia, Italy; 2 Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy; 3 Life and Health Sciences Research Institute, University of Minho, Braga, Portugal; 4 Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University of Rome, Rome, Italy


BACKGROUND: Recent experimental study showed a higher incidence of bladder cancer in presence of bladder detrusor muscle thickening. The aim of this study is to assess whether a higher detrusor muscle thickness (DWT) may be a risk factor of recurrence of non-muscle invasive urothelial bladder cancer (NMIBC).
METHODS: Men with histologically-confirmed diagnosis of NMIBC were prospectively enrolled in 4 centers between December 2015 and April 2017. DWT was measured by ultrasound and DWT>2.5mm was used as threshold for detrusor muscle thickening Patients underwent to adjuvant local treatment in according to their progression and recurrence risk computed by European Organization Research and Treatment of Cancer (EORTC) score for NMIBC. Every three months cystoscopy and urinary cytology were used to detect disease recurrence and progression. The main clinic-pathological variables were compared between patients with DWT≤2.5mm and DWT>2.5mm.
RESULTS: 100 patients (49.8%) with DWT >2.5mm were significantly older, had larger and more tumors and experienced more prior NMIBC than 101 (50.2%) patients with a DWT≤2.5mm. Recurrence and progression disease occurred more often and briefly in patients with a detrusor muscle thickening. At univariate analysis, DWT>2.5 was a predictive risk factors of cancer recurrence and progression, respectively: OR 4.9 (95% CI 2.5 - 9.5) p=0.001 and OR 2.21 (95% CI 1.71 - 4.73), p=0.001. Enclosing DWT in EORTC risk calculator significantly increased by 3% and 1% recurrence and progression risk assessment, respectively.
CONCLUSIONS: Detrusor muscle thickening may have a role in NMIBC course with a higher recurrence rate, however further confirmatory and elucidating studies are required.

KEY WORDS: Bladder cancer - Detrusor muscle - Bladder outlet obstruction

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Publication History

Article first published online: December 14, 2017
Manuscript accepted: December 1, 2017
Manuscript revised: September 19, 2017
Manuscript received: June 25, 2017

Cite this article as

Cicione A, Manno S, Ucciero G, Cantiello F, Damiano R, Lima E, et al. A larger detrusor wall thickness increases the risk of non muscle invasive bladder cancer recurrence and progression: result from a multicenter observational study. Minerva Urol Nefrol 2017 Dec 14. DOI: 10.23736/S0393-2249.17.02992-7

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