Antiplatelet İlaç Kullanımının Mesane Kanseri Tanısı Üzerindeki Etkileri: Kolaylaştırıcı mı, Zorlaştırıcı mı?

Year 2020, Volume: 15 Issue: 2, 109 - 114, 12.06.2020

Haci İbrahim Cimen , Deniz Gul

https://doi.org/10.33719/yud.595945

Abstract

Amaç:Mesane kanserinde en sık görülen semptom olan hematüri bazı ilaçların etkisiyle de ortaya çıkabilir. Bu çalışmanın amacı antiplatelet (AP) ilaçların mesane kanseri tanısındaki rolünü değerlendirmektir.

Gereç ve yöntemler:Üroloji kliniğimize Ocak 2013 - Aralık 2018 tarihleri ​​arasında başvuran ve primer mesane kanseri tanısı ile transüretral rezeksiyon (TUR) uygulanan hastalar retrospektif olarak incelendi. Hastalar AP ilaç kullanımına göre 2 gruba ayrıldı (grup 1: AP tedavisi almayan, grup 2: AP tedavisi alan). Gruplar demografik veriler, başvuru şikayeti, sigara içme durumu, tümör büyüklüğü, multifokalite, patolojik evre ve derece ile mesane kanseri risk grubu açısından karşılaştırıldı.

Bulgular:Çalışmaya; grup 1'de 233, grup 2'de 57 olmak üzere toplam 290 hasta alındı. Hastaların yaş ortalaması 68,69 ± 9,48 yıldı ve 246'sı (% 84,8) erkekti. Gruplar arasında yaş, cinsiyet, başvuru semptomu, sigara içme durumu, tümör büyüklüğü, multifokalite, patolojik evre, derece ve mesane kanseri risk grubu açısından istatistiksel olarak anlamlı fark yoktu.

Sonuç:Sonuçlarımıza göre, mesane kanserindeki AP ilaç kullanımının ilk tanıda patolojik sonuçlar, tümör boyutu, multifokalite ve başvuru semptomu üzerinde hiçbir etkisinin olmadığı ve mesane kanserinde erken veya gecikmiş tanıya neden olduğu sonucuna varılamayacağı tespit edildi.

Keywords

Antiplatelet , erken tanı , hematüri , mesane kanseri , transüretral rezeksiyon

Effects of Antiplatelet Therapy Use on the Diagnosis of Bladder Cancer: Is it a Facilitator or Complicator?

Abstract

Objective:Haematuria, which is the most common
presenting symptom in bladder cancer (BCa), may also occur with the effect of
some medications. The aim of this study was to evaluate the role of
antiplatelet (AP) drugs in the diagnosis of BCa.

Material and methods:Patients who applied to our urology clinic between January 2013 and December 2018 and underwent transurethral resections (TURs) for primary BCa were reviewed retrospectively. Patients were divided into 2 groups according to AP drug use (group 1: no AP therapy, group 2: recieving AP therapy). The groups were compared in terms of demographic data, complaint of admission, smoking status, tumor size, multifocality, pathologic stage and grade, and BCa risk group.

Results:A total of 290 patients, 233 in Group 1 and 57 in
Group 2, were included in the study. The mean age of the patients was 68.69 ± 9.48
years and 246 of (84.8%) patients were male. There was no statistically significant difference
between groups in terms of age, sex, presenting symptom, smoking status, tumor
size, multifocality, pathological stage and grade and BCa risk groups.

Conclusion:According to our results, AP drug use in BCa was found to
have no effect on pathologic results, tumor size, multifocality and presenting
symptom at the first diagnosis and can not be conclude that cause early or
delayed diagnosis in BCa.

Keywords

Antiplatelet , bladder cancer , early diagnosis , haematuria , transurethral resection

References

• 1. Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144:1941-53.
• 2. Kamat AM, Hahn NM, Efstathiou JA, et al. Bladder cancer. Lancet. 2016;388:2796-810.
• 3. DeGeorge KC, Holt HR, Hodges SC. Bladder Cancer: Diagnosis and Treatment. Am Fam Physician. 2017;96:507-14.
• 4. Babjuk M, Böhle A, Burger M, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2017;71:447-61.
• 5. Davis R, Jones JS, Barocas DA, et al.; American Urological Association. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol. 2012;188(6 Suppl):2473-81.
• 6. Hall MC, Chang SS, Dalbagni G, et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol. 2007;178:2314-30.
• 7. Golin AL, Howard RS. Asymptomatic microscopic hematuria. J Urol. 1980;124:389-91.
• 8. Ngo B, Papa N, Perera M, Bolton D, Sengupta S. Bladder cancer diagnosis during haematuria investigation - implications for practice guidelines. BJU Int. 2017;119:53-4.
• 9. Sharp VJ, Barnes KT, Erickson BA. Assessment of asymptomatic microscopic hematuria in adults. Am Fam Physician. 2013;88:747-54.
• 10. Baigent C, Blackwell L, Collins R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373:1849–60.
• 11. Shehab N, Lovegrove MC, Geller AI, Rose KO, Weidle NJ, Budnitz DS. US emergency department visits for outpatient adverse drug events, 2013-2014. JAMA. 2016;316:2115-25.
• 12. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955-62.
• 13. Gaist D, García Rodríguez LA, Hellfritzsch M, et al. Association of antithrombotic drug use with subdural hematoma risk. JAMA. 2017;317:836-46.
• 14. de Martino M, Shariat SF, Hofbauer SL, et al. Aurora A kinase as a diagnostic urinary marker for urothelial bladder cancer. World J Urol. 2015;33:105-10.
• 15. Karaoglu I, van der Heijden AG, Witjes JA. The role of urine markers, white light cystoscopy and fluorescence cystoscopy in recurrence, progression and follow-up of non-muscle invasive bladder cancer. World J Urol. 2014;32:651-9.
• 16. Sayyid RK, Sayyid AK, Klaassen Z, et al. Replacing surveillance cystoscopy with urinary biomarkers in followup of patients with non-muscle-invasive bladder cancer: Patients' and urologic oncologists' perspectives. Can Urol Assoc J. 2018;12:E210-E218.
• 17. Beukers W, van der Keur KA, Kandimalla R, et al. FGFR3, TERT and OTX1 as a Urinary Biomarker Combination for Surveillance of Patients with Bladder Cancer in a Large Prospective Multicenter Study. J Urol. 2017;197:1410-8.
• 18. Todenhöfer T, Hennenlotter J, Guttenberg P, et al. Prognostic relevance of positive urine markers in patients with negative cystoscopy during surveillance of bladder cancer. BMC Cancer. 2015;15:155.
• 19. Schmitz-Dräger BJ, Droller M, Lokeshwar VB, et al. Molecular markers for bladder cancer screening, early diagnosis, and surveillance: the /ICUD consensus. Urol Int. 2015;94:1-24.
• 20. Pashos CL, Botteman MF, Laskin BL, Redaelli A. Bladder cancer: epidemiology, diagnosis, and management. Cancer Pract. 2002;10:311–22.
• 21. Nathan AS, Sen S, Yeh RW. The risk of bleeding with the use of antiplatelet agents for the treatment of cardiovascular disease. Expert Opin Drug Saf. 2017;16:561-72.
• 22. Wallis CJD, Juvet T, Lee Y, et al. Association Between Use of Antithrombotic Medication and Hematuria-Related Complications. JAMA. 2017;318:1260-71.
• 23. Bhatt NR, Davis NF, Nolan WJ, et al. Incidence of Visible Hematuria Among Antithrombotic Agents: A Systematic Review of Over 175,000 Patients. Urology. 2018;114:27-32.
• 24. Goli RR, Contractor MM, Nathan A, Tuteja S, Kobayashi T, Giri J. Antiplatelet Therapy for Secondary Prevention of Vascular Disease Complications. Curr Atheroscler Rep. 2017;19:56.
• 25. Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a "set up" for vascular disease. Circulation. 2003;107:139-46.
• 26. Savji N, Rockman CB, Skolnick AH, et al. Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects. J Am Coll Cardiol. 2013;61:1736-43.
• 27. Hajar R. Risk Factors for Coronary Artery Disease: Historical Perspectives. Heart Views. 2017;18:109-14.
• 28. Picozzi S, Marenghi C, Ricci C, Bozzini G, Casellato S, Carmignani L. Risks and complications of transurethral resection of bladder tumor among patients taking antiplatelet agents for cardiovascular disease. Surg Endosc. 2014;28:116-21.
• 29. Prader R, De Broca B, Chevallier D, Amiel J, Durand M. Outcome of Transurethral Resection of Bladder Tumor: Does Antiplatelet Therapy Really Matter? Analysis of a Retrospective Series. J Endourol. 2017;31:1284-8.
• 30. Moschini M, Karnes RJ, Suardi N, et al. Potential Effect of Antiplatelet and Anticoagulant Therapy on the Timing of the Diagnosis of Bladder Cancer. Clin Genitourin Cancer. 2016;14:e245-250.