Ralf Böthig1, Christian Tiburtius2, Kai Fiebag2, Birgitt Kowald3, Sven Hirschfeld3, Roland Thietje3, Ines Kurze4, Wolfgang Schöps5, Holger Böhme6, Albert Kaufmann7, Michael Zellner8, Thura Kadhum9, Klaus Golka9. 1. Department Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Germany. r.boethig@bgk-hamburg.de. 2. Department Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Germany. 3. Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Hamburg, Germany. 4. Department of Paraplegiology and Neuro-Urology, Centre for Spinal Cord Injuries, Zentralklinik Bad Berka, Bad Berka, Germany. 5. Urological Practice, Sankt Augustin, Germany. 6. Department of Urology, Asklepios Klinik Barmbek, Hamburg, Germany. 7. Department of Neuro-Urology, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany. 8. Department of Urology and Neuro-Urology, Johannesbad Fachklinik, Bad Füssing, Germany. 9. Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund, Germany.
Abstract
PURPOSE: Life expectancy for people with traumatic spinal cord injury (SCI) is increasing due to advances in treatment methods and in neuro-urology. Thus, developing urinary bladder cancer (UBC) is gaining importance. METHODS: Single-centre retrospective evaluation of consecutive in- and out-patient data with spinal cord injury between January 1st, 1998 and December 31st, 2018 was carried out and data were compared with UBC data of the German population from the German Centre for Cancer Registry Data at Robert Koch Institute. RESULTS: A total of 37 (4 female, 33 male) out of 7004 patients with SCI were diagnosed with histologically proven UBC (median follow-up 85 months). Median age at UBC diagnosis was 54.0 years (general population: 74 years). The SCI patients had significantly (p < 0.0001, each) more frequent muscle-invasive tumors (81% ≥ T2) and unfavorable grading (76% G3), compared to the general population. Median survival was 13 months for transitional cell carcinoma (n = 31) and 4 months for squamous cell carcinoma (n = 5) (p = 0.0039), resp. The median survival of the 24 cystectomized patients was 15.0 months. Long-term suprapubic or indwelling catheterization was found in only eight patients for a total of only 5.09% (median 15.5 months) of the latency of all patients. No significant differences for T category and grading were observed between the bladder emptying methods intermittent catheterisation and catheter-free voiding. CONCLUSION: The results indicate that in patients with SCI bladder management even without permanent catheterization represents a considerable risk for the development of UBC.
PURPOSE: Life expectancy for people with traumatic spinal cord injury (SCI) is increasing due to advances in treatment methods and in neuro-urology. Thus, developing urinary bladder cancer (UBC) is gaining importance. METHODS: Single-centre retrospective evaluation of consecutive in- and out-patient data with spinal cord injury between January 1st, 1998 and December 31st, 2018 was carried out and data were compared with UBC data of the German population from the German Centre for Cancer Registry Data at Robert Koch Institute. RESULTS: A total of 37 (4 female, 33 male) out of 7004 patients with SCI were diagnosed with histologically proven UBC (median follow-up 85 months). Median age at UBC diagnosis was 54.0 years (general population: 74 years). The SCI patients had significantly (p < 0.0001, each) more frequent muscle-invasive tumors (81% ≥ T2) and unfavorable grading (76% G3), compared to the general population. Median survival was 13 months for transitional cell carcinoma (n = 31) and 4 months for squamous cell carcinoma (n = 5) (p = 0.0039), resp. The median survival of the 24 cystectomized patients was 15.0 months. Long-term suprapubic or indwelling catheterization was found in only eight patients for a total of only 5.09% (median 15.5 months) of the latency of all patients. No significant differences for T category and grading were observed between the bladder emptying methods intermittent catheterisation and catheter-free voiding. CONCLUSION: The results indicate that in patients with SCI bladder management even without permanent catheterization represents a considerable risk for the development of UBC.
Authors: Oliver Balzer; Ralf Böthig; Wolfgang Schöps; Roland Thietje; Armin Soave; Thura Kadhum; Klaus Golka Journal: Spinal Cord Ser Cases Date: 2021-11-29
Authors: Klaus Golka; Ralf Böthig; Wobbeke Weistenhöfer; Olaf P Jungmann; Steffi Bergmann; Michael Zellner; Wolfgang Schöps Journal: Urologie Date: 2022-09-26
Authors: Ralf Böthig; Christian Tiburtius; Wolfgang Schöps; Michael Zellner; Oliver Balzer; Birgitt Kowald; Sven Hirschfeld; Roland Thietje; Aki Pietsch; Ines Kurze; Martin Forchert; Thura Kadhum; Klaus Golka Journal: Mil Med Res Date: 2021-04-29
Authors: Roland Thietje; Birgitt Kowald; Ralf Böthig; Arndt P Schulz; Markus Northmann; Yannick Rau; Sven Hirschfeld Journal: J Clin Med Date: 2021-12-22 Impact factor: 4.241