Microscopic haematuria at time of diagnosis is associated with lower disease stage in patients with newly diagnosed bladder cancer

Daniel Ramirez, Amit Gupta, Daniel Canter, Brian Harrow, Ryan W. Dobbs, Victor Kucherov, Edward Mueller, Necole Streeper, Matthew A. Uhlman, Robert S. Svatek, Edward M. Messing, Yair Lotan

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Abstract

Objectives To determine whether the severity of haematuria (microscopic or gross) at diagnosis influences the disease stage at presentation in patients diagnosed with bladder cancer. Patients and Methods We conducted a multi-institutional observational cohort study of patients who were newly diagnosed with bladder cancer between August 1999 and May 2012. We reviewed the degree of haematuria, demographic information, clinical and social history, imaging, and pathology. The association of haematuria severity with incident tumour stage and grade was evaluated using logistic regression. Results Patients diagnosed with bladder cancer presented with gross haematuria (GH; 1 083, 78.3%), microscopic haematuria (MH; 189, 13.7%) or without haematuria (112, 8.1%). High-grade disease was found in 64% and 57.1% of patients presenting with GH and MH, respectively, and severity of haematuria was not associated with higher grade disease. Stage of disease at diagnosis for patients presenting with MH was Ta/carcinoma in situ (CIS) in 68.8%, T1 in 19.6%, and ≥T2 in 11.6%. Stage of disease at diagnosis for patients presenting with GH was Ta/CIS in 55.9%, T1 in 19.6%, and ≥T2 in 17.9%. On multivariate analyses, GH was independently associated with ≥T2 disease at diagnosis (odds ratio 1.69, 95% confidence interval 1.05-2.71, P = 0.03). Conclusions Among patients with newly diagnosed bladder cancer, presentation with GH is associated with a more advanced pathological stage. Earlier detection of disease, before development of GH, could influence survival in patients with bladder cancer. Type of haematuria at presentation does not impact grade of disease.

Original languageEnglish (US)
Pages (from-to)783-786
Number of pages4
JournalBJU International
Volume117
Issue number5
DOIs
StatePublished - May 1 2016

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Hematuria
Urinary Bladder Neoplasms
Carcinoma in Situ
Observational Studies
Early Diagnosis
Cohort Studies
Multivariate Analysis
Logistic Models
History
Odds Ratio
Demography
Confidence Intervals
Pathology
Survival

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Ramirez, Daniel ; Gupta, Amit ; Canter, Daniel ; Harrow, Brian ; Dobbs, Ryan W. ; Kucherov, Victor ; Mueller, Edward ; Streeper, Necole ; Uhlman, Matthew A. ; Svatek, Robert S. ; Messing, Edward M. ; Lotan, Yair. / Microscopic haematuria at time of diagnosis is associated with lower disease stage in patients with newly diagnosed bladder cancer. In: BJU International. 2016 ; Vol. 117, No. 5. pp. 783-786.
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title = "Microscopic haematuria at time of diagnosis is associated with lower disease stage in patients with newly diagnosed bladder cancer",
abstract = "Objectives To determine whether the severity of haematuria (microscopic or gross) at diagnosis influences the disease stage at presentation in patients diagnosed with bladder cancer. Patients and Methods We conducted a multi-institutional observational cohort study of patients who were newly diagnosed with bladder cancer between August 1999 and May 2012. We reviewed the degree of haematuria, demographic information, clinical and social history, imaging, and pathology. The association of haematuria severity with incident tumour stage and grade was evaluated using logistic regression. Results Patients diagnosed with bladder cancer presented with gross haematuria (GH; 1 083, 78.3{\%}), microscopic haematuria (MH; 189, 13.7{\%}) or without haematuria (112, 8.1{\%}). High-grade disease was found in 64{\%} and 57.1{\%} of patients presenting with GH and MH, respectively, and severity of haematuria was not associated with higher grade disease. Stage of disease at diagnosis for patients presenting with MH was Ta/carcinoma in situ (CIS) in 68.8{\%}, T1 in 19.6{\%}, and ≥T2 in 11.6{\%}. Stage of disease at diagnosis for patients presenting with GH was Ta/CIS in 55.9{\%}, T1 in 19.6{\%}, and ≥T2 in 17.9{\%}. On multivariate analyses, GH was independently associated with ≥T2 disease at diagnosis (odds ratio 1.69, 95{\%} confidence interval 1.05-2.71, P = 0.03). Conclusions Among patients with newly diagnosed bladder cancer, presentation with GH is associated with a more advanced pathological stage. Earlier detection of disease, before development of GH, could influence survival in patients with bladder cancer. Type of haematuria at presentation does not impact grade of disease.",
author = "Daniel Ramirez and Amit Gupta and Daniel Canter and Brian Harrow and Dobbs, {Ryan W.} and Victor Kucherov and Edward Mueller and Necole Streeper and Uhlman, {Matthew A.} and Svatek, {Robert S.} and Messing, {Edward M.} and Yair Lotan",
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doi = "10.1111/bju.13345",
language = "English (US)",
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Ramirez, D, Gupta, A, Canter, D, Harrow, B, Dobbs, RW, Kucherov, V, Mueller, E, Streeper, N, Uhlman, MA, Svatek, RS, Messing, EM & Lotan, Y 2016, 'Microscopic haematuria at time of diagnosis is associated with lower disease stage in patients with newly diagnosed bladder cancer', BJU International, vol. 117, no. 5, pp. 783-786. https://doi.org/10.1111/bju.13345

Microscopic haematuria at time of diagnosis is associated with lower disease stage in patients with newly diagnosed bladder cancer. / Ramirez, Daniel; Gupta, Amit; Canter, Daniel; Harrow, Brian; Dobbs, Ryan W.; Kucherov, Victor; Mueller, Edward; Streeper, Necole; Uhlman, Matthew A.; Svatek, Robert S.; Messing, Edward M.; Lotan, Yair.

In: BJU International, Vol. 117, No. 5, 01.05.2016, p. 783-786.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Microscopic haematuria at time of diagnosis is associated with lower disease stage in patients with newly diagnosed bladder cancer

AU - Ramirez, Daniel

AU - Gupta, Amit

AU - Canter, Daniel

AU - Harrow, Brian

AU - Dobbs, Ryan W.

AU - Kucherov, Victor

AU - Mueller, Edward

AU - Streeper, Necole

AU - Uhlman, Matthew A.

AU - Svatek, Robert S.

AU - Messing, Edward M.

AU - Lotan, Yair

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objectives To determine whether the severity of haematuria (microscopic or gross) at diagnosis influences the disease stage at presentation in patients diagnosed with bladder cancer. Patients and Methods We conducted a multi-institutional observational cohort study of patients who were newly diagnosed with bladder cancer between August 1999 and May 2012. We reviewed the degree of haematuria, demographic information, clinical and social history, imaging, and pathology. The association of haematuria severity with incident tumour stage and grade was evaluated using logistic regression. Results Patients diagnosed with bladder cancer presented with gross haematuria (GH; 1 083, 78.3%), microscopic haematuria (MH; 189, 13.7%) or without haematuria (112, 8.1%). High-grade disease was found in 64% and 57.1% of patients presenting with GH and MH, respectively, and severity of haematuria was not associated with higher grade disease. Stage of disease at diagnosis for patients presenting with MH was Ta/carcinoma in situ (CIS) in 68.8%, T1 in 19.6%, and ≥T2 in 11.6%. Stage of disease at diagnosis for patients presenting with GH was Ta/CIS in 55.9%, T1 in 19.6%, and ≥T2 in 17.9%. On multivariate analyses, GH was independently associated with ≥T2 disease at diagnosis (odds ratio 1.69, 95% confidence interval 1.05-2.71, P = 0.03). Conclusions Among patients with newly diagnosed bladder cancer, presentation with GH is associated with a more advanced pathological stage. Earlier detection of disease, before development of GH, could influence survival in patients with bladder cancer. Type of haematuria at presentation does not impact grade of disease.

AB - Objectives To determine whether the severity of haematuria (microscopic or gross) at diagnosis influences the disease stage at presentation in patients diagnosed with bladder cancer. Patients and Methods We conducted a multi-institutional observational cohort study of patients who were newly diagnosed with bladder cancer between August 1999 and May 2012. We reviewed the degree of haematuria, demographic information, clinical and social history, imaging, and pathology. The association of haematuria severity with incident tumour stage and grade was evaluated using logistic regression. Results Patients diagnosed with bladder cancer presented with gross haematuria (GH; 1 083, 78.3%), microscopic haematuria (MH; 189, 13.7%) or without haematuria (112, 8.1%). High-grade disease was found in 64% and 57.1% of patients presenting with GH and MH, respectively, and severity of haematuria was not associated with higher grade disease. Stage of disease at diagnosis for patients presenting with MH was Ta/carcinoma in situ (CIS) in 68.8%, T1 in 19.6%, and ≥T2 in 11.6%. Stage of disease at diagnosis for patients presenting with GH was Ta/CIS in 55.9%, T1 in 19.6%, and ≥T2 in 17.9%. On multivariate analyses, GH was independently associated with ≥T2 disease at diagnosis (odds ratio 1.69, 95% confidence interval 1.05-2.71, P = 0.03). Conclusions Among patients with newly diagnosed bladder cancer, presentation with GH is associated with a more advanced pathological stage. Earlier detection of disease, before development of GH, could influence survival in patients with bladder cancer. Type of haematuria at presentation does not impact grade of disease.

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DO - 10.1111/bju.13345

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