Clinical characteristics of bladder cancer in patients with spinal cord injury: the experience from a single centre.
BACKGROUND
Life expectancy for people with spinal cord injury has shown a marked increase due to modern advances in treatment methods and in neuro-urology. However, since life expectancy of people with paralysis increases, the risk of developing of urinary bladder cancer is gaining importance.


METHODS
Single-centre retrospective evaluation of patient data with spinal cord injuries and proven urinary bladder cancer and summary of the literature.


RESULTS
Between 1998 and 2014, 24 (3 female, 21 male) out of a total of 6599 patients with spinal cord injury were diagnosed with bladder cancer. The average age at bladder cancer diagnosis was 57.67 years, which is well below the average for bladder cancer cases in the general population (male: 73, female: 77). All but one patient had a latency period between the onset of the spinal paralysis and tumour diagnosis of more than 10 years. The median latency was 29.83 years. The median survival for these patients was 11.5 months. Of the 24 patients, 19 (79%) had muscle invasive bladder cancer at ≥T2 at the time of diagnosis. The type of neurogenic bladder (neurogenic detrusor overactivity or acontractility) and the form of bladder drainage do not appear to influence the risk. Long-term indwelling catheter drainage played only a minor role in the investigated patients.


CONCLUSIONS
The significantly younger age at onset and the frequency of invasive tumours at diagnosis indicate that spinal cord injury influences bladder cancer risk and prognosis as well. Early detection of bladder cancer in patients with spinal cord injury remains a challenge.
Department Neuro-Urology, Centre for Spinal Cord Injuries, BG Trauma Hospital Hamburg, Hamburg, Germany. r.boethig@bgk-hamburg.de.
Ralf
http://orcid.org/0000-0003-3037-8066
R
Böthig
Department of Paraplegiology and Neuro-Urology, Centre for Spinal Cord Injuries, Zentralklinik Bad Berka, Bad Berka, Germany.
Ines
I
Kurze
Department Neuro-Urology, Centre for Spinal Cord Injuries, BG Trauma Hospital Hamburg, Hamburg, Germany.
Kai
K
Fiebag
Department of Neuro-Urology, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany.
Albert
A
Kaufmann
Urological Practice, Sankt Augustin, Germany.
Wolfgang
W
Schöps
Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund, Germany.
Thura
T
Kadhum
Urological Department, Johannesbad Fachklinik Bad Füssing, Bad Füssing, Germany.
Michael
M
Zellner
Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund, Germany.
Klaus
K
Golka
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D002574:Cervical Vertebrae; D005260:Female; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications*; D015996:Survival Rate; D013904:Thoracic Vertebrae; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D055815:Young Adult
Bladder cancer; Bladder management; Neurogenic bladder dysfunction; Risk factors; Spinal cord injury