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Bladder management, severity of injury and period of latency: a descriptive study on 135 patients with spinal cord injury and bladder cancer

Spinal Cord, 2021 · DOI: https://doi.org/10.1038/s41393-021-00651-3 · Published: June 17, 2021

Spinal Cord InjuryUrologyOncology

Simple Explanation

This study looks at bladder cancer in people with spinal cord injuries. It examines how the type of bladder management, severity of the spinal cord injury, and the time since the injury affect the risk and characteristics of bladder cancer. The study found that bladder cancer tends to occur later in the course of spinal cord injury. Also, the time between the spinal cord injury and bladder cancer diagnosis was longer in patients who didn't use catheters or had lower motor neuron lesions. The research suggests that regular check-ups for bladder cancer should be more frequent as the time since the spinal cord injury increases. The parameters like severity of spinal cord lesion and bladder emptying methods are not suitable to define vulnerable subpopulations.

Study Duration
Jan 2012–Dec 2019
Participants
135 individuals with SCI/D
Evidence Level
Longitudinal study

Key Findings

  • 1
    No significant differences were found in tumor characteristics when stratified by bladder management, SCI/D severity, and ASIA classification.
  • 2
    The mean latency period between SCI/D onset and bladder cancer diagnosis was significantly longer in patients with catheter-free emptying methods.
  • 3
    The mean latency period between SCI/D onset and bladder cancer diagnosis was significantly longer in patients with LMNL compared to patients with UMNL.

Research Summary

This study, based on data from 135 SCI/D patients with bladder cancer, confirms that bladder cancer tends to occur at a younger age and with more advanced tumors in SCI/D patients. The study found no differences in tumor characteristics based on bladder emptying type or SCI/D severity, but it did find a longer latency period in patients using catheter-free methods or those with LMNL. The results suggest that bladder cancer screening should be intensified with increasing duration of SCI/D, but the level or severity of the spinal cord lesion does not noticeably affect tumor characteristics.

Practical Implications

Screening Timelines

The longer latency in catheter-free patients and those with LMNL could inform bladder cancer screening timelines.

Subpopulation Vulnerability

Severity of spinal cord lesions may not be a key determinant of bladder cancer risk, making broad screening more relevant.

Further Research

Future studies should compare patients with chronic indwelling catheters and those with catheter-free management to clarify tumor characteristics.

Study Limitations

  • 1
    Selection bias due to the study's longitudinal design.
  • 2
    Lack of an external control group for comparison.
  • 3
    Missing data on bladder cancer risk factors like tobacco smoking and occupational carcinogen exposure.

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