BACKGROUND: About 75% of urothelial bladder cancers are non-muscle invasive (NMIBC), and limited to mucosa (Ta or CIS) or sub-mucosa (T1). An increase of androgen expression and androgen receptors has a positive effect on oncogenic expression. We aimed to evaluate whether 5-alpha reductase inhibitors (5-ARI) have a role in NMIBC. METHODS: We retrospectively evaluated the clinical and pathological data of 423 patients with NMIBC who underwent transurethral bladder resection. We analysed the number of resections, number of total recurrences, time of recurrences, and histopathology details. The population was classified into two groups: treated and untreated with 5-ARIs. The enrolled patients were in treatment with 5ARIs for symptomatic prostatic hyperplasia for at least 12 months. Mean follow-up time was 30.43 months. RESULTS: Patients treated with 5-ARIs had a lower rate of recurrence (14%) than the untreated group (37%). There was a significant difference in the mean number of recurrences between the untreated and the treated group (p value: 0.006). Furthermore, the treated group showed a significantly greater number of low than high grade tumours, compared to the untreated group (p value ≤ 0.05). There was a significant decrease in the number of muscle invasive tumours in treated patients (p value = 0.032). The recurrence- free survival rate of patients treated with 5-ARIs was significantly higher (p value: 0.0001). CONCLUSIONS: Long-term treatment with 5- ARIs might reduce the risk of bladder tumour recurrence, extension of lesions and increase the recurrence-free survival rate. A long-term, randomized prospective study could definitively assess the possible role of these drugs.

Possible role of 5-alpha reductase inhibitors in non-invasive bladder urothelial neoplasm. Multicentre study / Pastore, Al; Fuschi, A; De Nunzio, C; Balzarro, M; Al Salhi, Y; Velotti, G; Martoccia, A; Capone, L; Amigoni, N; Falsaperla, M; Mattia, C; Artibani, W; Tubaro, A; Carbone, A. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - (2019).

Possible role of 5-alpha reductase inhibitors in non-invasive bladder urothelial neoplasm. Multicentre study

Pastore AL
;
Fuschi A;De Nunzio C;Al Salhi Y;Velotti G;Capone L;Falsaperla M;Mattia C;Tubaro A;Carbone A
2019

Abstract

BACKGROUND: About 75% of urothelial bladder cancers are non-muscle invasive (NMIBC), and limited to mucosa (Ta or CIS) or sub-mucosa (T1). An increase of androgen expression and androgen receptors has a positive effect on oncogenic expression. We aimed to evaluate whether 5-alpha reductase inhibitors (5-ARI) have a role in NMIBC. METHODS: We retrospectively evaluated the clinical and pathological data of 423 patients with NMIBC who underwent transurethral bladder resection. We analysed the number of resections, number of total recurrences, time of recurrences, and histopathology details. The population was classified into two groups: treated and untreated with 5-ARIs. The enrolled patients were in treatment with 5ARIs for symptomatic prostatic hyperplasia for at least 12 months. Mean follow-up time was 30.43 months. RESULTS: Patients treated with 5-ARIs had a lower rate of recurrence (14%) than the untreated group (37%). There was a significant difference in the mean number of recurrences between the untreated and the treated group (p value: 0.006). Furthermore, the treated group showed a significantly greater number of low than high grade tumours, compared to the untreated group (p value ≤ 0.05). There was a significant decrease in the number of muscle invasive tumours in treated patients (p value = 0.032). The recurrence- free survival rate of patients treated with 5-ARIs was significantly higher (p value: 0.0001). CONCLUSIONS: Long-term treatment with 5- ARIs might reduce the risk of bladder tumour recurrence, extension of lesions and increase the recurrence-free survival rate. A long-term, randomized prospective study could definitively assess the possible role of these drugs.
File allegati a questo prodotto
File Dimensione Formato  
Pastore_Possible-role_2019.pdf

embargo fino al 13/12/2020

Tipologia: Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 2.53 MB
Formato Adobe PDF
2.53 MB Adobe PDF Visualizza/Apri PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1340583
Citazioni
  • ???jsp.display-item.citation.pmc??? 2
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact