Factors associated with survival after bladder cancer in spinal cord injury.
OBJECTIVE
The purpose of this study was to evaluate factors influencing survival in individuals with spinal cord injury (SCI) and bladder cancer. We hypothesized that bladder cancer survivors would have undergone more intense genitourinary surveillance and would have had fewer risk factors for bladder cancer.


METHODS
Case-control study.


METHODS
Eight participants with SCI who had survived at least 5 years (survivors) with bladder cancer were compared with 12 SCI controls who had died due to bladder cancer. Data was obtained retrospectively through medical record review and were analyzed using a two-tailed Mann-Whitney and Fisher's exact tests.


RESULTS
The survivor and control groups were similar with regard to age at SCI, duration of SCI, age at bladder cancer diagnosis, and time utilizing an indwelling catheter. The proportion that developed squamous cell carcinoma was similar for the survivors and controls, at 37.5% and 44%, respectively. Survivors were more likely to be nonsmokers (P = 0.04), and have a history of squamous metaplasia (P = 0.05) and papillary cystitis (P = 0.03). Examining risk factors together, controls were more likely to have multiple risk factors for bladder cancer. The mean number of cystoscopies for the survivor and control groups, respectively, was 8.6 (range = 1-22, SE = 3.1) vs 18.9 (range = 4-48, SE = 6.6), and the mean number of bladder biopsies was 1.5 (range = 1-5, SE = 0.6) vs 4.2 (range = 1-11, SE = 2.0), respectively.


CONCLUSIONS
Bladder cancer survivors were less likely to have multiple genitourinary risk factors. Fewer screening cystoscopies and biopsies were performed in survivors of bladder cancer than in those who died of bladder cancer.
Department of Physical Medicine & Rehabilitation, National Rehabilitation Hospital, Washington, DC, USA. SuzanneL.Groah@Medstar.Net
Suzanne L
SL
Groah
Daniel P
DP
Lammertse
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D016022:Case-Control Studies; D003120:Colorado; D003558:Cystoscopy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D014556:Urine / Q000166:cytology