The prevalence of bladder cancer (BC) in neurological patients seems to be similar to that of the general population. However, they are more aggressive with a higher rate of muscle-invasive forms and squamous cells carcinomas. The aim of the current study was to report etiologies, management and outcomes of BC in neurological population.
Were enrolled all neurological patients with a BC diagnosed between 2004 and 2017. The following data were retrospectively reported: age, gender, duration of the disease, mode of discovery, histological type, treatment and outcomes.
In total, 27 patients were included: 11 spinal cord injuries, 7 Parkinson's disease, 5 multiple sclerosis, 3 head trauma, 3 brain strokes, 2 cerebral palsies and 1 spina bifida. The histological subtypes were as follows: 22 transitional cells carcinomas, 4 squamous cell carcinomas (SCC), one mucinous adenocarcinoma, one sarcomatoid and one neuroendocrine with 19 high-grade tumors and 15 muscle-invasive bladder cancer. Seven patients (26%) were diagnosed before 15 years history of neurogenic bladder. The mean follow-up was 14 months (1-210 months). Eight deaths were observed, with 5 related to bladder cancer. In our study, smoking habits, voiding mode, lithiasis or infection histories were not related with a more aggressive pattern, such as SCC.
The high rate of muscle-invasive bladder cancer and aggressive patterns justify neuro-urological follow-up, even before 15 years of neurogenic bladder.
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Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2017 Nov 22 [Epub ahead of print]
P Ali, C Lefevre, B Perrouin-Verbe, L Le Normand, J Rigaud, O Bouchot, A Levesque, M-A Perrouin-Verbe
Faculté de médecine d'Angers, 49100 Angers, France; Service de médecine physique et de réadaptation, CHU d'Angers, 49100 Angers, France., Service de médecine physique et réadaptation neurologique, hôpital Saint-Jacques, CHU de Nantes, 44000 Nantes, France., Clinique urologique, CHU de Nantes, Hôtel Dieu, Nantes, France., Clinique urologique, CHU de Nantes, Hôtel Dieu, Nantes, France. Electronic address: .