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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2012

01-11-2012 | Urologic Oncology

Prognostic Value of Renin–Angiotensin System Blockade in Non-muscle-invasive Bladder Cancer

Authors: Kazuyuki Yuge, MD, Akira Miyajima, MD, PhD, Nobuyuki Tanaka, MD, Suguru Shirotake, MD, Takeo Kosaka, MD, PhD, Eiji Kikuchi, MD, PhD, Mototsugu Oya, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2012

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Abstract

Background

To determine whether the administration of renin–angiotensin system (RAS) inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), affect disease outcome in non-muscle-invasive bladder cancer (NMIBC).

Methods

A total of 330 patients with initially diagnosed NMIBC were identified. We retrospectively investigated the clinical outcomes after transurethral resection of bladder tumor (TUR-BT) in patients who did or did not receive RAS inhibitors. The median follow-up period was 4.1 years.

Results

A total of 128 patients (38.8 %) experienced subsequent tumor recurrence, and stage progression was observed in 17 patients (5.2 %) during follow-up. Fifty-one patients (15.5 %) had received ACEI or ARB administration at transurethral resection. Multivariate analysis demonstrated that tumor multiplicity, absence of bacillus Calmette-Guérin instillation, and no administration of ACEI or ARB (P = 0.010, hazard ratio 2.26) were independent risk factors for subsequent tumor recurrence. The 5-year recurrence-free survival rate was 78.4 % in patients administered ACEIs or ARBs, and 53.3 % in their counterparts (P = 0.011).

Conclusions

The absence of RAS inhibitor administration was an independent risk factor for subsequent tumor recurrence in patients with initially diagnosed NMIBC. Our data support further investigation of the role of RAS inhibitors as a potential therapy to decrease tumor recurrence in NMIBC.
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Metadata
Title
Prognostic Value of Renin–Angiotensin System Blockade in Non-muscle-invasive Bladder Cancer
Authors
Kazuyuki Yuge, MD
Akira Miyajima, MD, PhD
Nobuyuki Tanaka, MD
Suguru Shirotake, MD
Takeo Kosaka, MD, PhD
Eiji Kikuchi, MD, PhD
Mototsugu Oya, MD, PhD
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2568-z

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