title: Shorter hemodialysis duration is a risk factor for the recurrence of urothelial carcinoma of the bladder in patients on maintenance hemodialysis.
abstract: OBJECTIVE
  To investigate the association of hemodialysis duration with the recurrence of urothelial carcinoma (UC) of the bladder and overall survival in patients undergoing maintenance hemodialysis (MHD).
  
  
  METHODS
  52 bladder cancer patients who underwent MHD at the Xiangya Hospital of The Central South University between 2001 and 2011 were enrolled in the study. The patients were divided into three groups according to hemodialysis duration, and patient mortality and tumor recurrence rates were analyzed. The association of hemodialysis duration with occurrence and recurrence of UC of the bladder was analyzed by Cox regression analysis. Survival was evaluated by the Kaplan-Meier method.
  
  
  RESULTS
  Out of 6266 chronic hemodialysis patients, 52 patients had UC of the bladder after the initiation of hemodialysis for 6 months. The mean age at hemodialysis onset was 55 years (IQR 36, 71). The major complaints were painless gross hematuria and urethral bloody discharge. Tumors were generally large and multifocal. The standardized incidence ratio of UC of the bladder was 43.9 compared with general population, and it was higher in women (76.7) and in the age group 61-65 years (186.6). The mean hemodialysis duration before the diagnosis of bladder cancer was 32 months. 30 (57.7 %) patients received hemodialysis no more than 3 years, 10 (19.2 %) patients received hemodialysis between 3 and 6 years, and 12 (23.1 %) patients received hemodialysis for more than 6 years.
  
  
  CONCLUSIONS
  Preoperative shorter hemodialysis duration is a risk factor for the occurrence and recurrence of UC of the bladder in patients undergoing MHD.
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: S-L
authors.initials: SL
authors.lastname: Liu
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China. urinologist_xyql@163.com.
authors.forename: L
authors.initials: L
authors.lastname: Qi
authors.affiliation: Department of Urology, The Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, 410008, China.
authors.forename: W-Q
authors.initials: WQ
authors.lastname: Han
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: B-S
authors.initials: BS
authors.lastname: Zhu
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: X
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Urology, The Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, 410008, China.
authors.forename: S-S
authors.initials: SS
authors.lastname: Jiang
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: M-F
authors.initials: MF
authors.lastname: Chen
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: W
authors.initials: W
authors.lastname: He
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: L-F
authors.initials: LF
authors.lastname: Liu
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: X-H
authors.initials: XH
authors.lastname: Hu
authors.affiliation: Department of Urology, The Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, 410008, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Urology, The Affiliated Cancer Hospital of Xiangya Medical School, Central South University, Changsha, 410008, China.
authors.forename: F-H
authors.initials: FH
authors.lastname: Zeng
authors.affiliation: Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, China.
authors.forename: X-B
authors.initials: XB
authors.lastname: Zu
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012307:Risk Factors; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology*
keywords: Bladder; Hemodialysis duration (HDD); Maintenance hemodialysis (MHD); Urothelial carcinoma (UC)