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1.
Eur J Nutr ; 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38839633

RESUMO

PURPOSE: High consumption of fruits and vegetables decrease the risk of bladder cancer (BC). The evidence of specific fruits and vegetables and the BC risk is still limited. METHODS: Fruit and vegetable consumptions in relation to BC risk was examined by pooling individual participant data from case-control studies. Unconditional logistic regression was used to estimate study-specific odds ratio's (ORs) with 95% confidence intervals (CIs) and combined using a random-effects model for intakes of total fruits, total vegetables, and subgroups of fruits and vegetables. RESULTS: A total of 11 case-control studies were included, comprising 5637 BC cases and 10,504 controls. Overall, participants with the highest intakes versus the lowest intakes of fruits in total (OR 0.79; 95% CI 0.68-0.91), citrus fruits (OR 0.81; 95% CI 0.65-0.98), pome fruits (OR 0.76; 95% CI 0.65-0.87), and tropical fruits (OR 0.84; 95% CI 0.73-0.94) reduced the BC risk. Greater consumption of vegetables in total, and specifically shoot vegetables, was associated with decreased BC risk (OR 0.82; 95% CI 0.68-0.96 and OR 0.87; 95% CI 0.78-0.96, respectively). Substantial heterogeneity was observed for the associations between citrus fruits and total vegetables and BC risk. CONCLUSION: This comprehensive study provides compelling evidence that the consumption of fruits overall, citrus fruits, pome fruits and tropical fruits reduce the BC risk. Besides, evidence was found for an inverse association between total vegetables and shoot vegetables intake.

2.
Aktuelle Urol ; 2024 Apr 10.
Artigo em Alemão | MEDLINE | ID: mdl-38599592

RESUMO

Apart from a few exceptions, there is currently little scientific evidence on the oncological relevance of neuro-urological diseases. Most research has been conducted into the association between long-term spinal cord injury with its consequences for the lower urinary tract and the occurrence of bladder cancer. These cancers differ in many ways from bladder cancers in patients without spinal cord injury: patients are 20 years younger on average, tumours are very often already muscle-invasive and poorly differentiated with a high proportion of squamous cell carcinomas, and the prognosis is poor. These characteristics also occur in spinal cord injury patients without permanent catheter drainage of the urinary bladder. Although the pathophysiological association has not been clarified in detail, the presence of a neurogenic bladder appears to be the decisive link between spinal cord injury and the occurrence of bladder cancer. Pathological pressure conditions in the urinary bladder and frequent urinary tract infections or asymptomatic bacteriuria resulting from neurogenic lower urinary tract dysfunction could be the decisive pathophysiological factors. In this respect, urinary bladder cancer in persons with a chronic spinal cord injury represents a model tumour after denervation. The clinically important question of screening requires future interdisciplinary research approaches.

3.
EXCLI J ; 22: 867-879, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37720238

RESUMO

Urinary bladder cancer, a smoking and occupation related disease, was subject of several genome-wide association studies (GWAS). However, studies on the course of the disease based on GWAS findings differentiating between muscle invasive bladder cancer (MIBC) and non-muscle invasive bladder cancer (NMIBC) are rare. Thus we investigated 4 single nucleotide polymorphisms (SNPs) detected in GWAS, related to the genes coding for TACC3 (transforming, acidic coiled-coil containing protein 3), for FGFR3 (fibroblast growth factor receptor 3), for PSCA (prostate stem cell antigen) and the genes coding for CBX6 (chromobox homolog 6) and APOBEC3A (apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like 3A). This study is based on 712 bladder cancer patients and 875 controls from 3 different case control studies in Germany. The 4 SNPs of interest (PSCA rs2294008 and rs2978974, FGFR3-TACC3 rs798766, and CBX6-APOBEC3A rs1014971) were determined by real-time polymerase chain reaction. The distribution of the 4 SNPs does not vary significantly between cases and controls in the entire study group and in the 3 local subgroups, including two former highly industrialized areas and a region without such history. Also, no significant differences in the bladder cancer subgroups of MIBC and NMIBC were observed. The 4 investigated SNPs do not noticeably contribute differently to the bladder cancer risk for the bladder cancer subgroups of MIBC and NMIBC.

5.
Urologie ; 61(11): 1198-1207, 2022 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-36161345

RESUMO

Occupation-related cancers are of considerable importance, which is not yet adequately recognized in the field of urology. The three numerically most significant entities are tumors of the urinary tract caused by carcinogenic aromatic amines or polycyclic aromatic hydrocarbons, renal cell cancer after high exposure to the solvent trichloroethylene, and mesotheliomas of the tunica vaginalis of the testis after exposure to asbestos; however, these can only be recognized as occupation-related if an occupational history regarding the hazard relevant to the organ bearing the tumor is documented from the beginning of employment, e.g. by a questionnaire. This is because the relevant exposures generally date back several decades. With the exception of high exposure to trichloroethylene, the substances mentioned can also environmentally trigger the same tumors. In the context of environmental risk factors, it is of considerable importance that smoking is now considered to be a trigger for some 50% of all bladder cancers in men and women; however, smoking cessation results in a reduction in smoking-related cancer risk of over 30% after only 3-4 years. Work and commuting accidents, which are considered occupational risks, can lead to urological sequelae. For example, increased tumors of the bladder can occur after spinal cord injury lasting longer than 10 years.


Assuntos
Neoplasias Renais , Mesotelioma , Tricloroetileno , Urologia , Masculino , Humanos , Feminino , Mesotelioma/etiologia , Ocupações , Neoplasias Renais/induzido quimicamente
6.
Urologie ; 61(11): 1186-1196, 2022 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-36173458

RESUMO

Physicians are obliged to report the suspected presence of an occupational disease to the German Social Accident Insurance Institutions or to the state authority responsible for occupational health and safety. In the field of urology, tumors of the urinary tract are the most common, followed by the less common renal cell cancer and mesothelioma of the tunica vaginalis testis; however, for such a suspicion to arise at all, sufficient knowledge of urological occupational diseases must be present and the occupational or work history over the entire training and working life since the beginning of employment must be collected. In daily life the notification often fails at this point. In addition to the legal foundation and the principal course of the procedure, this article explains how a relevant comprehensive medical history by means of questionnaires can contribute to the fact that neither too many or all tumor diseases are unreflectedly reported, nor that occupational diseases are overlooked due to the lack of a medical history or detailed knowledge (or fear of this). Urological sequelae of accidents are often not adequately appreciated in the primary process or may take a long time to develop. In this case reporting the aggravation of the consequences of the accident is essential.


Assuntos
Neoplasias Renais , Mesotelioma Maligno , Mesotelioma , Doenças Profissionais , Masculino , Humanos , Acidentes de Trabalho , Doenças Profissionais/diagnóstico , Mesotelioma/patologia
8.
Cancer Prev Res (Phila) ; 15(5): 319-326, 2022 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-35027464

RESUMO

Although evidence suggests that a positive family history of bladder cancer in first-degree relatives is an important risk factor for bladder cancer occurrence, results remain unclear. The influence of family history of nonbladder cancers and more distant relatives on bladder cancer risk is inconsistent. This research, therefore, aims to increase the understanding of the association between family history and bladder cancer risk based on worldwide case-control studies. In total 4,327 cases and 8,948 non-cases were included. Pooled ORs, with corresponding 95% confidence intervals (CI), were obtained using multilevel logistic regression models, adjusted by age, sex, ethnicity, smoking status, and smoking pack-years. The results show bladder cancer risk increased by having a first- or second-degree relative affected with bladder cancer (OR, 2.72; 95% CI, 1.55-4.77 and OR, 1.71; 95% CI, 1.22-2.40, respectively), and nonurologic cancers (OR, 1.61; 95% CI, 1.19-2.18). Moreover, bladder cancer risk increased by number of cancers affected first-degree relatives (for 1 and >1 first-degree relatives: OR, 1.42; 95% CI, 1.02-2.04; OR, 2.67; 95% CI, 1.84-3.86, respectively). Our findings highlight an increased bladder cancer risk for a positive bladder cancer family history in first- and second-degree relatives, and indicate a possible greater effect for an increment of numbers of affected relatives. PREVENTION RELEVANCE: This study found a positive association between family history and bladder cancer in first- and second-degree relatives, with an added effect attributed to smoking. Given the detriments of bladder cancer, at-risk individuals should receive family history screening and tobacco cessation and avoidance counseling.


Assuntos
Neoplasias da Bexiga Urinária , Estudos de Casos e Controles , Família , Feminino , Humanos , Masculino , Anamnese , Fatores de Risco , Neoplasias da Bexiga Urinária/etiologia , Neoplasias da Bexiga Urinária/genética
9.
World J Urol ; 40(8): 1961-1970, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35092468

RESUMO

PURPOSE: Radical cystectomy in people with spinal cord injury (SCI) provides numerous additional difficulties, compared to able-bodied people. Therefore, it is important to obtain information from an experienced team about optimally managing these patients. METHODS: Surgical procedures, based on the experience of 12 radical cystectomies in SCI patients with bladder cancer between January 1st, 2001, and December 31st, 2020, were recorded and the operative and perioperative clinical data were evaluated. Surgery was performed in a high-volume center by the surgeon most experienced in radical cystectomies, assisted by the neuro-urologist, involved in the care of the patient from the spinal cord center. Furthermore, a checklist based on the experience of the surgeon and the assisting neuro-urologist was developed. RESULTS: SCI patients mostly suffered from an advanced disease and were always operated by the same team. The hospital stays ranged from 23 to 134 days (median 42 days). Four of the patients suffered from a postoperative paralytic ileus. Otherwise, both the operation time and the intraoperative blood loss as well as intraoperative and postoperative complications were basically comparable with those in able-bodied patients. The special features of radical cystectomy in SCI bladder cancer patients are described. Furthermore, a checklist addressing preoperative red flags, intra-operative challenges and post-operative challenges is presented. CONCLUSION: Radical cystectomy in SCI patients should be performed in a high-volume department by the most experienced surgical team. The inclusion of the urologist caring for the patient from the spinal cord injury center is highly recommended.


Assuntos
Íleus , Traumatismos da Medula Espinal , Neoplasias da Bexiga Urinária , Cistectomia/métodos , Humanos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia , Traumatismos da Medula Espinal/complicações , Resultado do Tratamento , Bexiga Urinária , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/cirurgia
10.
Urologe A ; 61(3): 292-296, 2022 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-34652478

RESUMO

Mesotheliomas are very aggressive tumors, almost exclusively caused by asbestos. Four of the 5 mesotheliomas assessed in the years 2014-2020 were recognized as occupational diseases, the 5th case was discontinued due to lack of the patient's cooperation. Surgical exposure of the testis was performed under the suspected diagnoses of hydrocele (n = 3), spermatocele (n = 1) as well as "unknown" (n = 1). This proves that a histopathological examination of removed tissue is the gold standard in scrotal interventions. Every mesothelioma must always be reported as an occupational disease.


Assuntos
Mesotelioma Maligno , Mesotelioma , Hidrocele Testicular , Neoplasias Testiculares , Humanos , Masculino , Mesotelioma/diagnóstico , Mesotelioma/etiologia , Mesotelioma/cirurgia , Hidrocele Testicular/diagnóstico , Hidrocele Testicular/etiologia , Hidrocele Testicular/cirurgia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia
11.
Aktuelle Urol ; 53(2): 137-147, 2022 04.
Artigo em Alemão | MEDLINE | ID: mdl-34933348

RESUMO

Urinary bladder cancer is the second most common tumour disease after lung cancer leading to death in people with a spinal cord injury. This paper provides a comprehensive overview of the differences relevant to urologists between urinary bladder tumours in this population compared with urinary bladder tumours in the general population.People with a spinal cord injury are 1 to 2 decades younger on average at the time of tumour diagnosis than patients without a spinal cord injury. Histopathologic findings at the initial diagnosis of urinary bladder cancer in people with a spinal cord injury are much less favourable than for urinary bladder cancers in the general population. Muscle-invasive tumours and tumours with poor differentiation are much more common, and the proportion of squamous cell carcinomas is significantly higher. The incidence rises after more than 10 years of paralysis. Urinary bladder cancer mortality is significantly elevated and increases with the duration of paralysis. In diagnostic procedures and, in particular, in radical cystectomy, clinically important features have to be considered. For example, urodynamic examinations or cystoscopy may trigger autonomic dysreflexia with hypertensive crises and the risk of life-threatening bradycardia.In the case of radical cystectomy, frequent adhesions and callosities of the urinary bladder, among other things, must be taken into account intraoperatively. Severe paralysis, prolonged intestinal atony and other conditions are frequently observed after the surgical procedure due to neurogenic bowel dysfunction. Correct positioning of the patient immediately after surgery to avoid decubitus and to support breathing, as well as bowel management specific to spinal cord injury, must be strictly observed.Other special features of paraplegic patients with urinary bladder cancer that should also be considered in clinical practice, as well as considerations for screening for urinary bladder tumors, are presented in the article.


Assuntos
Disreflexia Autonômica , Traumatismos da Medula Espinal , Neoplasias da Bexiga Urinária , Bexiga Urinaria Neurogênica , Humanos , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/epidemiologia , Bexiga Urinaria Neurogênica/diagnóstico , Bexiga Urinaria Neurogênica/etiologia , Urodinâmica
12.
Spinal Cord Ser Cases ; 7(1): 102, 2021 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-34845202

RESUMO

INTRODUCTION: For individuals with spinal cord injury/disease (SCI/D) the risk of developing a stone in the upper urinary tract is up to six times higher than in the able-bodied population. Upper urinary tract carcinomas, in general, are rare and account for only 5-10% of all urinary tract carcinomas. It is believed that chronic upper urinary tract irritation caused by e.g., kidney stones or recurrent upper urinary tract infections may be associated with an increased risk of renal squamous cell carcinoma (RSCC). CASE PRESENTATION: We report on a 64-year-old male who suffered a spinal cord injury in 1981 resulting in a complete sensory and motor impairment below T6, AIS A. Recurrent left-sided kidney stone disease had to be treated repeatedly from 1984 onwards. Despite repeated surgical attempts, it was ultimately not possible to achieve stone clearance in the long term. Within the concept of life-long surveillance of SCI/D, the patient was examined regularly, including ultrasound examinations of the kidneys. Six months after the last control examination, the patient was admitted to our hospital with a locally advanced tumor of the left kidney, so that only the option of palliative treatment remained. Histologically an RSCC was found. DISCUSSION: As people with SCI/D have a higher risk of developing kidney stones, it is of utmost importance to check regularly for stone disease and, if necessary, treat with the aim of long-term stone clearance in order to protect renal function and to avert potentially malignant changes at an early stage.


Assuntos
Carcinoma de Células Escamosas , Cálculos Renais , Traumatismos da Medula Espinal , Infecções Urinárias , Carcinoma de Células Escamosas/complicações , Humanos , Cálculos Renais/etiologia , Cálculos Renais/cirurgia , Pelve Renal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Infecções Urinárias/complicações
13.
Urologe A ; 60(8): 1061-1072, 2021 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-34241641

RESUMO

Cancers can be triggered by occupational causes. In the field of urology, bladder cancer is by far the most frequent occupationally induced tumor disease. Causes are particularly carcinogenic aromatic amines and carcinogenic polycyclic aromatic hydrocarbons. The frequency of this disease has shifted over the last decades from the classical hazard in the chemical industry to the users. Among a variety of hazardous occupations, hairdressers and painters are the best known. Rarely, renal cell carcinoma can be triggered by high trichloroethylene exposure and mesothelioma of the tunica vaginalis testis by asbestos. If a disease that can be caused by occupational activities has been confirmed (e.g. urinary bladder cancer), the risk factors must be recorded by a complete occupational history from the first employment on in order to be able to report a suspected occupational disease. In addition, spinal cord injury due to occupational and commuting accidents can lead to urinary bladder cancer over the long term.


Assuntos
Neoplasias Renais , Doenças Profissionais , Exposição Ocupacional , Neoplasias da Bexiga Urinária , Urologia , Humanos , Masculino , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Neoplasias da Bexiga Urinária/induzido quimicamente , Neoplasias da Bexiga Urinária/epidemiologia
14.
Spinal Cord ; 59(9): 971-977, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34140636

RESUMO

STUDY DESIGN: Longitudinal study. OBJECTIVES: To describe the severity of spinal cord injury/disease (SCI/D), type and management of neurogenic lower urinary tract dysfunction, tumor characteristics, and bladder cancer latency period in SCI/D patients. SETTING: Spinal cord injury centers in Germany, Austria, and Switzerland. METHODS: Data of SCI/D patients diagnosed with bladder cancer were collected between Jan 2012-Dec 2019 in the course of annual surveys in the neuro-urological departments of all 28 centers. Demographic and paralysis-specific data, data on the type and management of neurogenic lower urinary tract dysfunction, and histopathological tumor characteristics were collected. RESULTS: Regarding histopathological tumor characteristics, no significant differences were found in 135 individuals with SCI/D when stratified for bladder management without chronic catheterization, SCI/D severity, and ASIA classification. The mean latency period between the onset of SCI/D and the diagnosis of bladder cancer was significantly longer in patients with catheter-free emptying methods compared to patients with intermittent catheterization, and in patients with LMNL (Lower Motor Neuron Lesion) compared to patients with UMNL (Upper Motor Neuron Lesion). CONCLUSIONS: Urinary bladder carcinomas are late events in the long-term course of SCI/D. Follow-up and approaches to screening must therefore be intensified with increasing duration of long-term SCI.


Assuntos
Traumatismos da Medula Espinal , Neoplasias da Bexiga Urinária , Bexiga Urinaria Neurogênica , Humanos , Estudos Longitudinais , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/terapia , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/terapia , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/terapia
15.
Mil Med Res ; 8(1): 29, 2021 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-33910625

RESUMO

BACKGROUND: Traumatic spinal cord injury (SCI) is also a combat-related injury that is increasing in modern warfare. The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge, and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI. METHODS: A study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids. Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients. General patient information, latency period, age at initial diagnosis, type of bladder management and survival of SCI patients with bladder cancer were collected and analysed. T category, grading and tumour entity in these patients were compared with those in the general population. Relevant bladder cancer risk factors in SCI patients were analysed. Furthermore, relevant published literature was taken into consideration. RESULTS: Initial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years (SD ± 10.7 years), i.e., approximately 20 years earlier as compared with the general population. These bladder cancers are significantly more frequently muscle invasive (i.e., T category ≥ T2) and present a higher grade at initial diagnosis. Furthermore, SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis. Consequently, the survival time is extremely unfavourable. A very important finding, for practical reasons is that, in the Hamburg study as well as in the literature, urinary bladder cancer is more frequently observed after 10 years or more of SCI. Based on these findings, a matrix was compiled where the various influencing factors, either for or against the recognition of an association between SCI and urinary bladder cancer, were weighted according to their relevance. CONCLUSIONS: The results showed that urinary bladder cancer in SCI patients differs considerably from that in able-bodied patients. The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.


Assuntos
Traumatismos da Medula Espinal/complicações , Neoplasias da Bexiga Urinária/etiologia , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros/estatística & dados numéricos , Traumatismos da Medula Espinal/epidemiologia , Fatores de Tempo , Neoplasias da Bexiga Urinária/epidemiologia , Ferimentos e Lesões/complicações
16.
Spinal Cord Ser Cases ; 6(1): 55, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32601273

RESUMO

STUDY DESIGN: Retrospective descriptive study. OBJECTIVES: To compare histopathological findings and the long-term course of SCI patients with bladder cancer found incidentally at the initial urological workup to those diagnosed with bladder cancer many years after the onset of SCI. SETTING: Spinal cord injury center in Germany. METHODS: Data and follow-up of consecutive in- and out-patients with SCI admitted at a tertiary spinal cord injury center between January 1, 1998 and December 31, 2018 were screened retrospectively. All patients with acquired SCI were evaluated for pathological findings in the urinary bladder present at the time of SCI on the initial urological workup. Data of 37 long-term SCI patients from the same center with diagnosed bladder cancer and data of the general German population served as reference groups. Descriptive statistics were applied. RESULTS: In total, four patients with bladder cancer at initial urological workup were assessed. They all had non-muscle invasive bladder cancer. Two of the patients were cystectomized 34 and 106 months after first bladder cancer diagnosis, due to relapsing tumor and progressive renal failure, respectively. In both cases no tumor was found in the resected bladder. All four patients are currently alive with no tumor and a mean follow-up of 105 months. CONCLUSIONS: In incidental bladder cancer observed at the initial urological workup after acquired SCI, the duration of SCI, at least in the first 5 years, does not noticeably contribute to a poor prognosis, i.e., progression to muscle invasive bladder cancer (≥T2) or a higher grading (G3).


Assuntos
Traumatismos da Medula Espinal/complicações , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/epidemiologia , Bexiga Urinaria Neurogênica/complicações , Bexiga Urinária/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estudos Retrospectivos , Bexiga Urinaria Neurogênica/epidemiologia
17.
Investig Clin Urol ; 61(3): 250-259, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32377600

RESUMO

Purpose: High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer. Quality of life is an important factor when discussing therapy options for high-risk prostate cancer. This study evaluated adverse effects and health-related quality of life (HRQOL). Materials and Methods: Ninety male patients (median age, 71 years; range, 50 to 79 years) with high-risk prostate cancer underwent HDR-BT after EBRT between December 2009 and January 2017 with a median follow-up of 43 months. A total of 57 patients (69.5%) answered the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life of Cancer Patients questionnaire (QLQ-C30; ver. 3.0), and 8 patients died during follow-up. In order to put the results of this study in context, we compared the results with reference data from the EORTC QLQ-C30 Scoring Manual. Correlations of prostate-specific antigen (PSA) values, International Prostate Symptom Score, and HRQOL measures were calculated. Results: The study participants reported better physical functioning and better global health compared with the reference data, but worse social, role, and cognitive functioning. We found negative statistically significant correlations between the last-measured PSA value and social functioning (p>0.01), cognitive functioning, pain, and constipation (all p<0.05). Toxicity rates were 10.0% for gastrointestinal and 12.2% for genitourinary adverse effects. All reported complications for toxicity were Grade I. Conclusions: The described therapy results in high biochemical control rates with minimal adverse effects. Compared with reference groups, the HRQOL of this study cohort was acceptable. PSA values during follow-up seem to be a possible indicator to influence HRQOL.


Assuntos
Braquiterapia/efeitos adversos , Braquiterapia/métodos , Neoplasias da Próstata/radioterapia , Qualidade de Vida , Idoso , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Radioterapia/efeitos adversos , Radioterapia/métodos , Dosagem Radioterapêutica , Medição de Risco
18.
Br J Nutr ; 124(6): 611-619, 2020 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-32321598

RESUMO

At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case-control and one nested case-cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.


Assuntos
Mineração de Dados , Alimentos , Neoplasias da Bexiga Urinária/epidemiologia , Algoritmos , Estudos de Casos e Controles , Dieta , Feminino , Humanos , Incidência , Internacionalidade , Masculino , Fatores de Risco
19.
World J Urol ; 38(11): 2827-2834, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31932948

RESUMO

PURPOSE: Life expectancy for people with traumatic spinal cord injury (SCI) is increasing due to advances in treatment methods and in neuro-urology. Thus, developing urinary bladder cancer (UBC) is gaining importance. METHODS: Single-centre retrospective evaluation of consecutive in- and out-patient data with spinal cord injury between January 1st, 1998 and December 31st, 2018 was carried out and data were compared with UBC data of the German population from the German Centre for Cancer Registry Data at Robert Koch Institute. RESULTS: A total of 37 (4 female, 33 male) out of 7004 patients with SCI were diagnosed with histologically proven UBC (median follow-up 85 months). Median age at UBC diagnosis was 54.0 years (general population: 74 years). The SCI patients had significantly (p < 0.0001, each) more frequent muscle-invasive tumors (81% ≥ T2) and unfavorable grading (76% G3), compared to the general population. Median survival was 13 months for transitional cell carcinoma (n = 31) and 4 months for squamous cell carcinoma (n = 5) (p = 0.0039), resp. The median survival of the 24 cystectomized patients was 15.0 months. Long-term suprapubic or indwelling catheterization was found in only eight patients for a total of only 5.09% (median 15.5 months) of the latency of all patients. No significant differences for T category and grading were observed between the bladder emptying methods intermittent catheterisation and catheter-free voiding. CONCLUSION: The results indicate that in patients with SCI bladder management even without permanent catheterization represents a considerable risk for the development of UBC.


Assuntos
Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células de Transição/epidemiologia , Carcinoma de Células de Transição/etiologia , Traumatismos da Medula Espinal/complicações , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Cateterismo Urinário
20.
Artigo em Inglês | MEDLINE | ID: mdl-31421736

RESUMO

Industrial production and use of boron compounds have increased during the last decades, especially for the manufacture of borosilicate glass, fiberglass, metal alloys and flame retardants. This study was conducted in two districts of Balikesir; Bandirma and Bigadic, which geographically belong to the Marmara Region of Turkey. Bandirma is the production and exportation zone for the produced boric acid and some borates and Bigadic has the largest B deposits in Turkey. 102 male workers who were occupationally exposed to boron from Bandirma and 110 workers who were occupationally and environmentally exposed to boron from Bigadic participated to our study. In this study the DNA damage in the sperm, blood and buccal cells of 212 males was evaluated by comet and micronucleus assays. No significant increase in the DNA damage in blood, sperm and buccal cells was observed in the residents exposed to boron both occupationally and environmentally (p = 0.861) for Comet test in the sperm samples, p = 0.116 for Comet test in the lymphocyte samples, p = 0.042 for micronucleus (MN) test, p = 0.955 for binucleated cells (BN), p = 1.486 for condensed chromatin (CC), p = 0.455 for karyorrhectic cells (KHC), p = 0.541 for karyolitic cells (KLY), p = 1.057 for pyknotic cells (PHC), p = 0.331 for nuclear bud (NBUD)). No correlations were seen between blood boron levels and tail intensity values of the sperm samples, lymphocyte samples, frequencies of MN, BN, KHC, KYL, PHC and NBUD. The results of this study came to the same conclusions of the previous studies that boron does not induce DNA damage even under extreme exposure conditions.


Assuntos
Boro/toxicidade , Ensaio Cometa , Dano ao DNA , Células Epidérmicas/efeitos dos fármacos , Linfócitos/efeitos dos fármacos , Mucosa Bucal/citologia , Espermatozoides/efeitos dos fármacos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Monitoramento Biológico , Boro/sangue , Fatores de Confusão Epidemiológicos , Células Epidérmicas/química , Humanos , Linfócitos/química , Masculino , Testes para Micronúcleos , Exposição Ocupacional , Fumar/epidemiologia , Espermatozoides/química , Inquéritos e Questionários , Fatores de Tempo , Turquia
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