Prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer.
OBJECTIVE
To investigate the prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer.


METHODS
We retrospectively reviewed data from 237 patients diagnosed with non-muscle-invasive bladder cancer. Pyuria was defined as urine containing ≥5 white blood cells per high power field. The association between clinicopathological factors and recurrence was assessed by Cox univariate and multivariate analyses.


RESULTS
Preoperative pyuria was found in 116 (49.0%) patients. Pyuria was significantly associated with advanced age, positive cytology, multiple tumors, large tumor size, non-papillary tumors, T1 tumors and high-grade tumors. In univariate analysis of the entire patient population, pyuria, positive urine cytology, multiple tumors, pT1 tumors and no bacillus Calmette-Guérin were significantly associated with recurrence. Multivariate analysis showed that pyuria was an independent predictor of recurrence (hazard ratio 3.332, 95% confidence interval 2.052-5.410; P < 0.001), along with positive urine cytology, multiple tumors and no bacillus Calmette-Guérin therapy. Subanalysis of the patients who underwent bacillus Calmette-Guérin therapy also showed that pyuria was an independent predictor of recurrence (hazard ratio 2.062, 95% confidence interval 1.085-3.918, P = 0.027). The 2-year recurrence-free survival rate for patients with pyuria was significantly lower than for patients without pyuria (65.5% vs 80.7%; P = 0.027).


CONCLUSIONS
Preoperative pyuria seems to be significantly associated with recurrence in patients with non-muscle-invasive bladder cancer, and it might be a useful predictor for recurrence after bacillus Calmette-Guérin therapy.
Department of Urology, Tokyo Medical University, Tokyo, Japan.
Naoya
N
Satake
Department of Urology, Tokyo Medical University, Tokyo, Japan.
Yoshio
Y
Ohno
Department of Urology, Tokyo Medical University, Tokyo, Japan.
Jun
J
Nakashima
Department of Urology, Tokyo Medical University, Tokyo, Japan.
Makoto
M
Ohori
Department of Urology, Tokyo Medical University, Tokyo, Japan.
Masaaki
M
Tachibana
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis; D011776:Pyuria / Q000175:diagnosis*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology*; D055815:Young Adult
D001500:BCG Vaccine
Calmette-Guérin; bacillus; bladder cancer; non-muscle-invasive bladder cancer; prognosis; pyuria