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  4. Urinary bladder cancer as a late sequela of traumatic spinal cord injury

Urinary bladder cancer as a late sequela of traumatic spinal cord injury

Military Medical Research, 2021 · DOI: https://doi.org/10.1186/s40779-021-00322-7 · Published: May 8, 2021

Spinal Cord InjuryOncologyTrauma

Simple Explanation

This study investigates the link between spinal cord injuries (SCI) and the later development of bladder cancer, especially in the context of modern warfare where SCI is becoming more common. The research highlights that bladder cancer tends to appear earlier and be more aggressive in SCI patients compared to the general population. The study also provides a tool to help doctors assess whether bladder cancer in an SCI patient is related to their injury.

Study Duration
January 1998 to December 2019
Participants
40 SCI patients with bladder cancer out of 7396 treated SCI patients
Evidence Level
Not specified

Key Findings

  • 1
    SCI patients are diagnosed with bladder cancer approximately 20 years earlier than the general population.
  • 2
    Bladder cancers in SCI patients are more frequently muscle invasive and present a higher grade at initial diagnosis.
  • 3
    SCI patients exhibit a higher proportion of squamous cell carcinoma compared to the general population.

Research Summary

This study analyzes bladder cancer in patients with spinal cord injuries (SCI), finding that it occurs earlier and is more aggressive than in the general population. The research highlights a significantly increased risk of muscle-invasive bladder cancer and squamous cell carcinoma in SCI patients. An algorithm is presented to aid clinical assessment of the correlation between SCI and bladder cancer, considering various influencing factors.

Practical Implications

Early Detection

Increased awareness and screening for bladder cancer should be implemented in SCI patients, especially after 10 years post-injury.

Personalized Assessment

The provided algorithm can assist medical professionals in determining the likelihood of a causal relationship between SCI and bladder cancer for individual patients, influencing treatment and compensation decisions.

Improved Treatment Strategies

Recognizing the distinct characteristics of bladder cancer in SCI patients may lead to the development of more effective and tailored treatment approaches.

Study Limitations

  • 1
    Lack of reliable data on the frequency of SCI in Germany or other countries.
  • 2
    The distinction between symptomatic UTI and asymptomatic bacteriuria.
  • 3
    Inconsistent data regarding bladder stones as an independent risk factor.

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