.: ORİJİNAL ARAŞTIRMA
Antikoagülan/Antiagregan İlaç Kullanımının Mesane Kanserinin Primer Tanı Evresine Etkisi: Retrospektif Kesitsel Çalışma
The Effect of Anticoagulant/Antiagregan Drug Usage on the Primary Diagnosis Stage of Bladder Cancer: A Retrospective Cross-sectional Study
J Reconstr Urol. 2023;13(2):47-52
doi: 10.5336/urology.2023-95961
Makale Dili: TR
Tam Metin
Ücretsiz Erişim
ÖZET
Amaç: Bu çalışmada, makroskobik hematüri sonrası primer mesane kanseri tespit edilen hastalarda antikoagülan ve/veya antiagregan ilaç kullanımının hastalığın teşhisindeki evresine olan etkisini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışma retrospektif olarak makroskobik hematüri gelişimi sonrasında primer mesane kanseri tespit edilen hastalar arasında yapıldı. Hastaların yaş, cinsiyet, sigara kullanımı, Amerikan Anesteziyoloji Derneği skoru kaydedildi. Nonürotelyal mesane kanseri olanlar, pür karsinoma in situ olarak raporlanan olgular, komşu organ invazyonu olarak patolojik tanı alan hastalar dâhil edilmedi. Hastaların tümör sayısı, boyutu, T evresi ve tümör derecesi kaydedildi. Hastaların Avrupa Üroloji Derneği mesane kanseri risk gruplandırması (düşük, orta veya yüksek) kaydedildi. Hastalar antikoagülan ve/veya antiagregan tedavi (AAT) kullanım durumuna göre AAT (+) ve AAT (-) olarak 2 gruba ayrıldı. 'Her iki grubun sosyodemografik ve histopatolojik özellikleri karşılaştırmalı olarak analiz edildi. Bulgular: Çalışmaya retrospektif olarak taranan ve kriterlere uyan 153 hasta dâhil edildi. Hastaların ortalama yaşı 64,69±12,25 idi. Hastalardan 54'ünün (%35,2) AAT (+) ve 99'unun (%64,8) AAT (-) grupta olduğu hesaplandı. Her iki grubun analizinde yaş, cinsiyet, tümör sayısı açısından anlamlı fark olmadığı görüldü (p>0,05). Tümör boyutu <3 cm (%75,9'a karşı %62,6; p=0,091) olan hastaların oranı AAT (+) grubunda daha fazla olsa da anlamlı fark izlenmedi. Kas invaziv hastalık oranı (≥T2) (%17,1'e karşı %3,7; p=0,015) ve yüksek dereceli mesane kanseri oranının (%46,4'e karşı %27,7; p=0,024) AAT (-) grupta istatistiksel anlamlı olarak daha fazla olduğu hesaplandı. Rekürrens risk skorlamasına göre Avrupa Kanser Araştırma ve Tedavi Organizasyonu ≤5 olan (%66,6'ya karşı %45,4; p=0,012) hastaların AAT (+) grupta daha fazla olduğu görüldü. Sonuç: Bu çalışmada, makroskobik hematüri ile tanı alan primer mesane kanserinde AAT kullanımının hastalığın daha düşük evre ve derecede saptanması ile ilişkili olduğu sonucuna varıldı.
Anahtar Kelimeler: Mesane kanseri; makroskobik hematüri; antiagregan ilaçlar; antikoagülan ilaçlar
Amaç: Bu çalışmada, makroskobik hematüri sonrası primer mesane kanseri tespit edilen hastalarda antikoagülan ve/veya antiagregan ilaç kullanımının hastalığın teşhisindeki evresine olan etkisini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışma retrospektif olarak makroskobik hematüri gelişimi sonrasında primer mesane kanseri tespit edilen hastalar arasında yapıldı. Hastaların yaş, cinsiyet, sigara kullanımı, Amerikan Anesteziyoloji Derneği skoru kaydedildi. Nonürotelyal mesane kanseri olanlar, pür karsinoma in situ olarak raporlanan olgular, komşu organ invazyonu olarak patolojik tanı alan hastalar dâhil edilmedi. Hastaların tümör sayısı, boyutu, T evresi ve tümör derecesi kaydedildi. Hastaların Avrupa Üroloji Derneği mesane kanseri risk gruplandırması (düşük, orta veya yüksek) kaydedildi. Hastalar antikoagülan ve/veya antiagregan tedavi (AAT) kullanım durumuna göre AAT (+) ve AAT (-) olarak 2 gruba ayrıldı. 'Her iki grubun sosyodemografik ve histopatolojik özellikleri karşılaştırmalı olarak analiz edildi. Bulgular: Çalışmaya retrospektif olarak taranan ve kriterlere uyan 153 hasta dâhil edildi. Hastaların ortalama yaşı 64,69±12,25 idi. Hastalardan 54'ünün (%35,2) AAT (+) ve 99'unun (%64,8) AAT (-) grupta olduğu hesaplandı. Her iki grubun analizinde yaş, cinsiyet, tümör sayısı açısından anlamlı fark olmadığı görüldü (p>0,05). Tümör boyutu <3 cm (%75,9'a karşı %62,6; p=0,091) olan hastaların oranı AAT (+) grubunda daha fazla olsa da anlamlı fark izlenmedi. Kas invaziv hastalık oranı (≥T2) (%17,1'e karşı %3,7; p=0,015) ve yüksek dereceli mesane kanseri oranının (%46,4'e karşı %27,7; p=0,024) AAT (-) grupta istatistiksel anlamlı olarak daha fazla olduğu hesaplandı. Rekürrens risk skorlamasına göre Avrupa Kanser Araştırma ve Tedavi Organizasyonu ≤5 olan (%66,6'ya karşı %45,4; p=0,012) hastaların AAT (+) grupta daha fazla olduğu görüldü. Sonuç: Bu çalışmada, makroskobik hematüri ile tanı alan primer mesane kanserinde AAT kullanımının hastalığın daha düşük evre ve derecede saptanması ile ilişkili olduğu sonucuna varıldı.
Anahtar Kelimeler: Mesane kanseri; makroskobik hematüri; antiagregan ilaçlar; antikoagülan ilaçlar
ABSTRACT
Objective: We aimed to investigate the effect of anticoagulant and/or anti-aggregant drug use on the stage of diagnosis of the disease in patients with primary bladder cancer after macroscopic hematuria. Material and Methods: The study was conducted retrospectively among patients with primary bladder cancer after the development of macroscopic hematuria. Age, gender, smoking, American Society of Anesthesiology scores of the patients were recorded. Patients with nonurothelial bladder cancer, carcinoma in-situ, and adjacent organ invasion were not included. The tumor number, size, T stage and tumor grade of the patients were recorded. European Association of Urology bladder cancer risk group (low, moderate, or high) were recorded. The patients were divided into two groups as AAT (+) and AAT (-) according to their use of anticoagulant and/or anti-aggregant therapy (AAT). Sociodemographic characteristics, histopathological characteristics of the both groups were analyzed comparatively. Results: A total of 153 patients who were retrospectively screened and met the criteria were included in the study. The mean age of the patients was 64.69±12.25. It was calculated that 54 (35.2%) of the patients were in the AAT (+) and 99 (64.8%) patients were in the AAT (-) group. There was no significant difference in terms of age, gender and tumor number (p>0.05). Although the proportion of patients with tumor size T2) (17.1% vs 3.7%; p=0.015) and high-grade bladder cancer rate (46.4% vs. 27.7%; p=0.024) were calculated to be higher in the AAT (-) group. According to the recurrence risk score, patients with a European Cancer Research and Treatment Organization score of ≤5 (66.6% vs. 45.4%; p=0.012) were found to be more common in the AAT (+) group. Conclusion: It was concluded that the use of AAT provoked the development of macroscopic hematuria and enabled the detection of bladder cancer at an earlier stage.
Keywords: Bladder cancer; macroscopic hematuria; antiaggregant drugs; anticoagulant drugs
Objective: We aimed to investigate the effect of anticoagulant and/or anti-aggregant drug use on the stage of diagnosis of the disease in patients with primary bladder cancer after macroscopic hematuria. Material and Methods: The study was conducted retrospectively among patients with primary bladder cancer after the development of macroscopic hematuria. Age, gender, smoking, American Society of Anesthesiology scores of the patients were recorded. Patients with nonurothelial bladder cancer, carcinoma in-situ, and adjacent organ invasion were not included. The tumor number, size, T stage and tumor grade of the patients were recorded. European Association of Urology bladder cancer risk group (low, moderate, or high) were recorded. The patients were divided into two groups as AAT (+) and AAT (-) according to their use of anticoagulant and/or anti-aggregant therapy (AAT). Sociodemographic characteristics, histopathological characteristics of the both groups were analyzed comparatively. Results: A total of 153 patients who were retrospectively screened and met the criteria were included in the study. The mean age of the patients was 64.69±12.25. It was calculated that 54 (35.2%) of the patients were in the AAT (+) and 99 (64.8%) patients were in the AAT (-) group. There was no significant difference in terms of age, gender and tumor number (p>0.05). Although the proportion of patients with tumor size T2) (17.1% vs 3.7%; p=0.015) and high-grade bladder cancer rate (46.4% vs. 27.7%; p=0.024) were calculated to be higher in the AAT (-) group. According to the recurrence risk score, patients with a European Cancer Research and Treatment Organization score of ≤5 (66.6% vs. 45.4%; p=0.012) were found to be more common in the AAT (+) group. Conclusion: It was concluded that the use of AAT provoked the development of macroscopic hematuria and enabled the detection of bladder cancer at an earlier stage.
Keywords: Bladder cancer; macroscopic hematuria; antiaggregant drugs; anticoagulant drugs
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