R Böthig1, W Schöps2, M Zellner3, K Fiebag4, B Kowald5, S Hirschfeld6, R Thietje6, I Kurze7, H Böhme8, A Kaufmann9, O Jungmann10, J Zumbé11, D Porres11, G Lümmen12, M Nehiba13, T Kadhum14,15, M Forchert16, K Golka14. 1. Abteilung Neuro-Urologie, Querschnittgelähmten-Zentrum, BG Klinikum Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Deutschland. R.Boethig@bgk-hamburg.de. 2. , Sankt Augustin, Deutschland. 3. Abteilung für Urologie und Neuro-Urologie, Johannesbad Fachklinik, Bad Füssing, Deutschland. 4. Abteilung Neuro-Urologie, Querschnittgelähmten-Zentrum, BG Klinikum Hamburg, Bergedorfer Str. 10, 21033, Hamburg, Deutschland. 5. Biomechanisches Labor, BG Klinikum Hamburg, Hamburg, Deutschland. 6. Querschnittgelähmten-Zentrum, BG Klinikum Hamburg, Hamburg, Deutschland. 7. Querschnittgelähmten-Zentrum, Klinik für Paraplegiologie und Neuro-Urologie, Zentralklinik Bad Berka, Bad Berka, Deutschland. 8. Klinik für Urologie, Asklepios Klinik Barmbek, Hamburg, Deutschland. 9. Zentrum für Kontinenz und Neuro-Urologie, Krankenhaus St. Franziskus, Kliniken Maria Hilf GmbH, Mönchengladbach, Deutschland. 10. Urologische Klinik Lindenthal, Malteser Krankenhaus St. Hildegardis, Köln, Deutschland. 11. Klinik für Urologie, Klinikum Leverkusen, Leverkusen, Deutschland. 12. Urologische Abteilung, St. Josef Hospital, Betriebsstätte St. Josef Troisdorf, GFO Kliniken Troisdorf, Troisdorf, Deutschland. 13. Abteilung Neuro-Urologie, Werner-Wicker-Klinik, Bad Wildungen, Deutschland. 14. Zentrale Einrichtung Klinische Arbeitsmedizin, Leibniz-Institut für Arbeitsforschung an der TU Dortmund (IfADo), Dortmund, Deutschland. 15. Mittelrhein-Klinik Fachklinik für psychosomatische Rehabilitation, Boppard, Bad Salzig, Deutschland. 16. Berufsgenossenschaft Holz und Metall, Stabsstelle UV-Recht, Bielefeld, Deutschland.
Abstract
BACKGROUND: There is to date no convincing literature that has assessed the association between traumatic spinal cord injury (SCI) and the later development of urinary bladder cancer. The aim of this work is to present medical experts as well as the national accident insurance and the social courts decision-making aids based on the latest medical scientific knowledge, for assessment of this causal association. MATERIALS AND METHODS: A study conducted between April 1998 and March 2017 in the BG Trauma Hospital Hamburg forms the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 32 out of 6432 treated outpatient and inpatient SCI patients. Furthermore, relevant published literature was taken into consideration for the decision-making aids. RESULTS: It was found that urinary bladder cancer in SCI patients occurs at a considerably younger age as compared to the general population, more frequently shows muscle invasive carcinoma with a higher grade at first diagnosis and a higher proportion of the more aggressive squamous cell carcinoma than that of the general population. Correspondingly, the survival time is extremely unfavorable. For medical experts a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance. CONCLUSION: The results showed that urinary bladder cancer in SCI patients differs considerably from that of able-bodied patients. These differences drastically shorten the survival time. A study on patients with spina bifida, i.e., a congenital spinal cord disorder, corroborates these observations. They indicate histopathological differences that have so far been intangible.
BACKGROUND: There is to date no convincing literature that has assessed the association between traumatic spinal cord injury (SCI) and the later development of urinary bladder cancer. The aim of this work is to present medical experts as well as the national accident insurance and the social courts decision-making aids based on the latest medical scientific knowledge, for assessment of this causal association. MATERIALS AND METHODS: A study conducted between April 1998 and March 2017 in the BG Trauma Hospital Hamburg forms the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 32 out of 6432 treated outpatient and inpatient SCIpatients. Furthermore, relevant published literature was taken into consideration for the decision-making aids. RESULTS: It was found that urinary bladder cancer in SCIpatients occurs at a considerably younger age as compared to the general population, more frequently shows muscle invasive carcinoma with a higher grade at first diagnosis and a higher proportion of the more aggressive squamous cell carcinoma than that of the general population. Correspondingly, the survival time is extremely unfavorable. For medical experts a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance. CONCLUSION: The results showed that urinary bladder cancer in SCIpatients differs considerably from that of able-bodied patients. These differences drastically shorten the survival time. A study on patients with spina bifida, i.e., a congenital spinal cord disorder, corroborates these observations. They indicate histopathological differences that have so far been intangible.
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