Document Detail


Renal transplant recipients and patients with end stage renal disease present with more advanced bladder cancer.
MedLine Citation:
PMID:  19683766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Renal transplant recipients have an increased incidence of bladder cancer. It is unknown whether these cancers are more aggressive than those in nontransplanted cases and whether this is also true for cases with end stage renal disease without renal transplantation. MATERIALS AND METHODS: Surveillance, Epidemiology and End Results-Medicare data identified 97,942 patients with bladder cancer diagnosed between 1988 and 2002. We compared gender, race, tumor stage and histology at diagnosis among patients with a renal transplant, end stage renal disease or neither condition. The statistical significance of differences in the distribution of patient and tumor variables was assessed using the chi-square statistic (categorical variables) and single factor ANOVA tests of difference in means (continuous variables). RESULTS: Renal transplant recipients (58) were younger at diagnosis than those with end stage renal disease (400) or with neither diagnosis (97,484) (p <0.0001). Muscle invasive disease (stage T2 or greater) at presentation was more common in renal transplant recipients (37%, p = 0.04) and patients with end stage renal disease (33%, p = 0.0001) than in patients without these conditions (24%). Most renal transplant recipients were diagnosed with bladder cancer within 4 years of transplantation. Patients with a renal transplant (17%, p = 0.001) and end stage renal disease (12%, p <0.0001) also had a higher proportion of nonurothelial tumors than the remaining population (6.5%). CONCLUSIONS: Renal transplant recipients and patients with end stage renal disease present with higher stage bladder cancer than those without these conditions despite closer medical supervision. Since most renal transplant recipients were diagnosed with bladder cancer within 4 years of undergoing renal transplantation, consideration should be given to bladder cancer screening of such patients in this period.
Authors:
Behfar Ehdaie; George J Stukenborg; Dan Theodorescu
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-08-15
Journal Detail:
Title:  The Journal of urology     Volume:  182     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-14     Completed Date:  2009-10-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1482-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Urology, University of Virginia, Charlottesville, Virginia, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Disease Progression
Female
Humans
Kidney Failure, Chronic / complications*,  surgery*
Kidney Transplantation / adverse effects*
Male
Middle Aged
Retrospective Studies
Urinary Bladder Neoplasms / epidemiology,  etiology*,  pathology*
Grant Support
ID/Acronym/Agency:
CA104106/CA/NCI NIH HHS
Comments/Corrections
Comment In:
J Urol. 2009 Oct;182(4):1487   [PMID:  19683768 ]

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