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- Title
Chronic kidney disease as a risk factor for recurrence and progression in patients with primary non-muscle-invasive bladder cancer.
- Authors
Kobatake, Kohei; Hayashi, Tetsutaro; Black, Peter C; Goto, Keisuke; Sentani, Kazuhiro; Kaneko, Mayumi; Yasui, Wataru; Mita, Koji; Teishima, Jun; Matsubara, Akio
- Abstract
Objectives To investigate the relationship between chronic kidney disease and primary non-muscle-invasive bladder cancer. Methods Disease outcomes were analyzed in 418 patients treated with transurethral resection for primary non-muscle-invasive bladder cancer, and were correlated to traditional risk factors as well as chronic kidney disease stage according to estimated glomerular filtration rate: ≥60 (G1-2), 45-59 (G3a) or <45 (G3b-5). Results The median follow-up time was 40.0 months. There were 287 (68.7%), 98 (23.4%), and 33 (7.9%) patients with G1-2, G3a and G3b-5 chronic kidney disease, respectively. T1 tumor was present in 29.6% of G1-2, 43.9% of G3a and 51.4% of G3b-5 chronic kidney disease ( P = 0.004). The proportion of histological grade 3 non-muscle-invasive bladder cancer was higher in G3a and G3b-5 than G1-2 ( P < 0.001). Higher chronic kidney disease stage was associated with worse recurrence-free ( P < 0.001) and progression-free survival ( P = 0.017). In multivariable analysis, G3b-5 was found to be an independent predictor for recurrence ( hazard ratio 1.87; P = 0.004) and progression ( hazard ratio 2.96; P = 0.019). Chronic kidney disease stage was also strongly associated with the European Association of Urology bladder cancer risk groups ( P < 0.001), and with shorter time to recurrence and progression in each group. Conclusions Chronic kidney disease predicts the clinical outcome of primary non-muscle-invasive bladder cancer. Adding chronic kidney disease to the conventional risk factors might increase the accuracy of risk stratification.
- Subjects
BLADDER cancer; KIDNEY diseases; CANCER; DISEASES; TRANSURETHRAL prostatectomy
- Publication
International Journal of Urology, 2017, Vol 24, Issue 8, p594
- ISSN
0919-8172
- Publication type
Article
- DOI
10.1111/iju.13389