The association between postvoid residual and response to standard therapy in male and female patients with non-muscle-invasive bladder cancer.

Abstract

The urinary retention is recognized as a promoting factor for bladder cancer, but its role as prognostic factor of therapeutic response has not yet been widely considered. To correlate bladder outlet characteristics with short-term response to treatment in non-muscle-invasive bladder cancer. We carried out a case-control study on 600 consecutive patients with a first diagnosis of non-muscle-invasive bladder cancer, recruited at the first endoscopic follow-up visit after standard treatment: 200 patients were not tumor-free (cases) and 400 were tumor-free (controls). Patients were compared based on baseline and bladder-outlet characteristics ("functional parameters": postvoid residual volume [PVR], International Prostatic Symptoms Score, perceived quality of bladder outlet). t Test, χ2 test, receiver operating characteristic curves, logistic correlations, and multivariate analysis were applied. The cases had higher statistically significant PVR values compared with controls. We reported a linear correlation of no-tumor-free status with PVR (R2 = 0.087, p < 0.005); the receiver operating characteristic curves revealed an area under the curve of 0.824 (95%confidence interval, 0.783-0.865; optimal PVR cutoff, 50 mL). In the multivariate analysis, age, American Society of Anesthesiologists score ≥2, risk category ≥intermediate, and all functional parameters represented independent factors for no-tumor-free status. Urinary retention could represent a prognostic factor of treatment response, and its active treatment should be considered as an important therapeutic step into the clinical management of bladder cancer patients.