Abstract

BACKGROUND & OBJECTIVE: In Pakistan, urinary bladder cancer is one of the top ten malignancies. The most important concern after its treatment is tumor recurrence. Recent literature claimed that pre-operative pyuria in patients undergoing transurethral resection of bladder tumor was associated with significantly higher frequency of recurrence. However, there was controversy in existing literature and no such local published material was available which necessitated the present study. To determine the frequency of pre-operative pyuria in patients undergoing transurethral resection of bladder tumor for non-muscle invasive bladder cancer (NMIBC) with post-operative instillation of Bacillus Calmette Guerin (BCG) and to compare the frequency of tumor recurrence in patients with and without pre-operative pyuria.
 METHODOLOGY: It was a comparative study. This study involved 280 patients of both genders aged between 20-80 years. Pre-operative pyuria was diagnosed if early morning midstream urine specimen showed ≥10 white blood cells/HPF. Outcome variable was frequency of recurrence after 12 weeks of treatment on check cystoscopy.
 RESULTS: The mean age of the patients was 57.1±8.5 years. There were 236 (84.3%) male and 44 (15.7%) female patients in the study. 155 (55.4%) patients were tobacco smoker. Pre-operative pyuria was diagnosed in 127 (45.4%) patients while tumor recurrence was observed in 183 (65.4%) patients. The frequency of tumor recurrence was significantly higher in patients with pre-operative pyuria (85.8% vs. 48.4%; p<0.001).
 CONCLUSION: Pre-operative pyuria was a frequent finding in patients with non-muscle invasive bladder tumor and was associated with higher frequency of tumor recurrence which warrants routine screening of such patients for pyuria and increased frequency of tumor recurrence.

Highlights

  • In Pakistan, urinary bladder cancer is one of the top ten malignancies in men and most common malignancy in both men and women [1]

  • Bladder cancer is classified as non-muscle invasive bladder cancer (NMIBC), pTa and pT1 and muscle invasive bladder cancer (MIBC) pT2 to pT4

  • Cystectomy is recommended as the standard of care after Bacillus Calmette Guerin (BCG) failure in patients with NMIBC and cancer-specific survival has been reported to be over 90% . [4,5] Identification of patients at higher risk of tumor recurrence is utmost important while treating NMIBC and is an area of hot scientific research

Read more

Summary

Introduction

In Pakistan, urinary bladder cancer is one of the top ten malignancies in men and most common malignancy in both men and women [1]. Recent literature claimed that pre-operative pyuria in patients undergoing transurethral resection of bladder tumor was associated with significantly higher frequency of recurrence. To determine the frequency of pre-operative pyuria in patients undergoing transurethral resection of bladder tumor for non-muscle invasive bladder cancer (NMIBC) with post-operative instillation of Bacillus Calmette Guerin (BCG) and to compare the frequency of tumor recurrence in patients with and without pre-operative pyuria. The frequency of tumor recurrence was significantly higher in patients with pre-operative pyuria (85.8% vs 48.4%; p

Objectives
Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call