Preoperative pyuria predicts the presence of high-grade bladder carcinoma in patients with bladder tumors

Poletajew, Sławomir; Gajewska, Dominika; Kaczmarek, Krystian; Krajewski, Wojciech; Łykowski, Marcin; Sondka-Migdalska, J.; Borowik, Michał; Buraczyński, Paweł; Dzięgała, Mateusz; Przudzik, Maciej; Słojewski, Marcin; Kryst, Piotr

doi:10.5173/ceju.2020.0289

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…Due to the long interval between the preoperative urine laboratory tests and recurrence or progression, preoperative pyuria itself may not have directly affected the oncological outcome of BCG-treated NMIBC. For this reason, we hypothesised that preoperative pyuria reflects disease aggressiveness [26] or a peritumoural inflammatory response [27], which can directly affect a BCG immunotherapy response. Therefore, we carefully considered preoperative pyuria as a predictive marker of BCG unresponsiveness that may indirectly affect RFS or PFS.…”

Section: Discussionmentioning

confidence: 99%

Pyuria as a Predictive Marker of Bacillus Calmette–Guérin Unresponsiveness in Non-Muscle Invasive Bladder Cancer

Suh

Yuk

Jeong

et al. 2021

JCM

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This study aims to investigate the clinical role of preoperative pyuria for predicting bacillus Calmette–Guérin (BCG) unresponsiveness in non-muscle invasive bladder cancer (NMIBC). We performed a logistic regression analysis on 453 patients with NMIBC who were treated with BCG immunotherapy after a transurethral resection of bladder tumours, to evaluate predictive factors of BCG unresponsiveness. We also analysed univariate and multivariable survival data to estimate the prognostic impact of pyuria. Of the total study population, 37.6% (170/453) of patients had BCG unresponsiveness. A multivariable logistic regression analysis revealed that a history of upper urinary tract cancer (odds ratio (OR): 1.86, 95% confidence interval (CI): 1.04–3.32, p-value = 0.035) and the presence of pyuria (OR: 1.51, 95% CI: 1.01–2.27, p = 0.047) and tumour multiplicity (OR: 1.80, 95% CI: 1.18–2.75, p-value < 0.001) were significant predictors of BCG unresponsiveness. A Cox proportional hazards analysis model showed that pyuria was a significant prognostic factor for progression-free survival (hazard ratio: 4.51, 95% CI: 1.22–16.66, p = 0.024). A history of upper urinary tract cancer and the presence of pyuria and tumour multiplicity are predictive markers of BCG unresponsiveness. For patients with NMIBC who have preoperative pyuria, treatment using BCG should be considered cautiously.

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Section: Discussionmentioning

confidence: 99%

Pyuria as a Predictive Marker of Bacillus Calmette–Guérin Unresponsiveness in Non-Muscle Invasive Bladder Cancer

Suh

Yuk

Jeong

et al. 2021

JCM

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“…The currently used intravesical adjuvant therapies do not sufficiently limit the recurrence rate of urinary bladder cancer [ 2 ]. In addition, patients with urinary bladder cancer and co-existing pyuria had a significantly higher rate of high-grade tumors [ 3 ]. Antibiotic prophylaxis before surgical treatment of bladder cancer lowers the risk of infection complications.…”

Section: Introductionmentioning

confidence: 99%

Influence of Antibiotic Administration on the Urinary Bladder Cancer Early Recurrence Rate

Kowalski

Drewa

Adamowicz

et al. 2022

Journal of Oncology

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Bladder cancer tends to recur, making treatment one of the most expensive in oncology. The limited efficacy and high cost of adjuvant therapies in the treatment of bladder cancer prompt research on new drugs which could replace them. In vitro studies have established that antibiotics can have a cytostatic and cytotoxic effect on urinary bladder cancer cells. The objective of the study was to investigate the influence of antibiotics on the recurrence rate of bladder cancer. In a retrospective study, we analyzed a group of 199 patients with urinary bladder cancer from four urological centers. The study groups consisted of 40 patients who received ciprofloxacin and 83 patients who received beta-lactams as perioperative antimicrobial prophylaxis. The control group included 76 patients who did not get perioperative antimicrobial prophylaxis. The groups were analyzed for risk stratification, degree of malignancy, and size of the primary tumor. The average follow-up time was 24 months. The main focus of the study was to investigate the early recurrence rate of bladder cancer among studied groups, which could correlate with the effectiveness of currently used intravesical instillations. Additionally, cancer’s early progression was examined. Regardless of the division used, the highest recurrence rate was found in the ciprofloxacin group. There were no statistical differences in the recurrence rate between patients who received beta-lactams and patients who did not receive any antibiotics. In addition, there were no differences due to the progression rate between the groups. Perioperative antibiotic administration does not influence the early recurrence rate in patients with nonmuscle invasive urothelial bladder cancer.

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Relationship between Preoperative Pyuria and Bacille Calmette-Guerin Treatment in Intravesical Recurrence after Transurethral Resection of High-Risk, Non-Muscle Invasive, Bladder Carcinoma: A Retrospective Study of Human Data

Tsukamoto

Sazuka

Hattori

et al. 2023

Cancers

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Some researchers have found that preoperative pyuria is a risk factor for recurrence after transurethral resection of high-risk non-muscle invasive bladder cancer. However, to our knowledge, none have clarified the risks associated with pyuria according to bacille Calmette-Guerin (BCG) treatment status. We retrospectively selected patients with high-risk non-muscle invasive bladder cancer according to Japanese Urological Association guidelines. Pyuria was defined as ≥10 white blood cells per high-powered field. We analyzed recurrence-free rates (RFS) in 424 patients who had and had not undergone BCG treatment. The median duration of follow-up was 45.2 months. According to multivariate analysis, postoperative intravesical BCG induction and preoperative pyuria were independent risk factors for intravesical recurrence in the whole study cohort. We found no significant risk factors for recurrence in the BCG-treated group (n = 179). In the non-BCG-treated group (n = 245), patients with pyuria were much more frequently female and more often had T1 disease than patients without pyuria. According to univariate and multivariate analysis, preoperative pyuria is an independent risk factor for intravesical recurrence. There was no significant difference in the severity of pyuria between the BCG and non-BCG-treated groups. Aggressive BCG treatment may need to be considered in patients with high-risk NMIBC and pyuria.

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Preoperative pyuria predicts the presence of high-grade bladder carcinoma in patients with bladder tumors

Cited by 3 publications

References 26 publications

Pyuria as a Predictive Marker of Bacillus Calmette–Guérin Unresponsiveness in Non-Muscle Invasive Bladder Cancer

Pyuria as a Predictive Marker of Bacillus Calmette–Guérin Unresponsiveness in Non-Muscle Invasive Bladder Cancer

Influence of Antibiotic Administration on the Urinary Bladder Cancer Early Recurrence Rate

Relationship between Preoperative Pyuria and Bacille Calmette-Guerin Treatment in Intravesical Recurrence after Transurethral Resection of High-Risk, Non-Muscle Invasive, Bladder Carcinoma: A Retrospective Study of Human Data

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