Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris, France.
La Conception Hospital, Department of Urology, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Neurourol Urodyn. 2018 Apr;37(4):1386-1395. doi: 10.1002/nau.23457. Epub 2017 Nov 23.
To perform a systematic review of the literature regarding epidemiology, diagnosis, management and prognosis of bladder cancer in the neuro-urological patient population, in order to serve as a basis for future recommendations and research.
A systematic review was performed according to the PRISMA-Preferred Reporting Items for Systematic Reviews and Meta-Analyzes Statement. Embase was searched for studies providing data on epidemiology, diagnosis, management and prognosis of bladder cancer in neuro-urological patients.
After screening 637 abstracts, 15 studies (13 retrospective and 2 prospective studies) were included in this study. We identified 332 patients (0.3%) who were diagnosed with bladder cancer. This mostly affected mostly men (59.3%) and spinal cord injured patients (98.8%). Mean age at diagnosis was 56.1 years. Bladder cancer occurred after a long period of evolution of the neurological disease (24.9 years). Gross hematuria was the predominating presenting symptom (31.6% of cases). Indwelling urethral or supra-pubic catheters were used in 44.5% of patients. The most frequent histological subtype of bladder cancer was transitional cell carcinoma (53.1%), followed by squamous cell carcinoma (33.5%). Muscle-invasive bladder cancer was reported in 67.7% of patients. The mean cancer-specific mortality rate was of 47.1%.
The prevalence and high mortality rate of bladder cancer in neuro-urological patients underlines the importance of long-term follow-up in this specific population. This highlights the necessity of further studies in this field.
对神经泌尿科患者膀胱癌的流行病学、诊断、治疗和预后进行系统评价，为未来的建议和研究提供依据。
根据 PRISMA-Preferred Reporting Items for Systematic Reviews and Meta-Analyzes 声明进行系统评价。在 Embase 上搜索提供神经泌尿科患者膀胱癌流行病学、诊断、治疗和预后数据的研究。
筛选 637 篇摘要后，纳入了 15 项研究（13 项回顾性研究和 2 项前瞻性研究）。共发现 332 例（0.3%）诊断为膀胱癌的患者。这些患者主要为男性（59.3%）和脊髓损伤患者（98.8%）。诊断时的平均年龄为 56.1 岁。膀胱癌在神经疾病长期演变后发生（24.9 年）。主要表现为肉眼血尿（31.6%的病例）。44.5%的患者使用留置尿道或耻骨上导尿管。膀胱癌最常见的组织学亚型为移行细胞癌（53.1%），其次为鳞状细胞癌（33.5%）。报告肌层浸润性膀胱癌患者占 67.7%。癌症特异性死亡率平均为 47.1%。
神经泌尿科患者膀胱癌的患病率和高死亡率强调了对这一特定人群进行长期随访的重要性。这突出了该领域进一步研究的必要性。
