High prevalence of airway obstruction and pulmonary emphysema in urothelial (renal pelvis,ureter, and bladder) cancer patients |
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Institution: | 1. Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin D09 V2N0, Ireland;1. Department of Urology, Mayo Clinic, Rochester, Minnesota;2. Center for Innovation, Mayo Clinic, Rochester, Minnesota;3. Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota;1. Department of Thoracic Surgery, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama, Fukushima, Japan;2. Department of Respiratory Medicine, Ohta Nishinouchi Hospital, 2-5-20, Nishinouchi, Koriyama, Fukushima, Japan;1. Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan;2. Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan;3. Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan;4. Center for Clinical Oncology, Okayama University Hospital, Okayama, Japan;1. FUJIFILM Corporation, 2-26-30 Nishiazabu, Minato-ku, Tokyo, 106-8620, Japan;2. Department of Diagnostic Radiology, Fukujuji Hospital, 3-1-24 Matsuyama, Kiyose-city, Tokyo, 204-8522, Japan;3. Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan |
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Abstract: | BackgroundCigarette smoking is a major cause of COPD, with patients also presenting complications that stem from other smoking-related diseases, including urothelial cancer. However, the prevalence of COPD or airflow obstruction in urothelial cancer patients has not been well studied.MethodsWe investigated the prevalence of airflow obstruction (FEV1/FVC < 70%) in newly diagnosed urothelial cancer patients and identified the risk factors for airflow obstruction in existing urothelial cancer patients. Additionally, we compared the characteristics of subjects who had been diagnosed with both airflow obstruction and urothelial cancer, and subjects whose airflow obstruction was discovered during health screenings.ResultsA total of 217 patients were newly diagnosed with urothelial cancer during the study period at our institution. Among all patients, 210 (96.8%) underwent an evaluable lung function test, in which 38.6% (81 patients) displayed airflow obstruction defined as FEV1/FVC < 70%. In urothelial cancer patients, age, smoking index (pack-years), and BMI proved to be significant risk factors for airflow obstruction in multivariate logistic regression (p = 0.007, p < 0.0001, and p = 0.035, respectively). Gender, cancer stage, and cancer location were not significant risk factors. Patients with both airflow obstruction and urothelial cancer showed a more advanced emphysematous change than subjects presenting with airflow obstruction alone (unpaired t-test, p = 0.0003).ConclusionsAirflow obstruction was identified in 38.6% of urothelial cancer patients. Age, smoking index (pack-years), and BMI were significant risk factors. A significantly higher emphysematous score was observed in subjects with urothelial cancer than in subjects with airway obstruction alone. |
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Keywords: | Chronic obstructive pulmonary disease Urothelial cancer Pulmonary function test Airflow obstruction Emphysema COPD"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"chronic obstructive pulmonary disease FEV1"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"forced expiratory volume in one second FVC"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"forced vital capacity CT"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"computed tomography BMI"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"body mass index |
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