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Prognostic value of preoperative pyuria in patients with non‐muscle‐invasive bladder cancer
Author(s) -
Satake Naoya,
Ohno Yoshio,
Nakashima Jun,
Ohori Makoto,
Tachibana Masaaki
Publication year - 2015
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12788
Subject(s) - pyuria , medicine , bladder cancer , hazard ratio , univariate analysis , confidence interval , urology , proportional hazards model , cancer , gastroenterology , multivariate analysis , urine
Objectives 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.