Bladder cancer in patients with spina bifida: observation from an adult clinic

Abstract

Study design Retrospective descriptive study of patients with spina bifida and bladder cancer. Objectives To compare the medical characteristics of patients diagnosed with spina bifida and bladder cancer to those patients diagnosed with spina bifida only. Setting Spina Bifida Clinic in Hospital Universitari Vall d'Hebron (Barcelona, Spain). Methods Patients registered in the Spina Bifida Clinic between 1990 and 2015 and born before 1996 were included. We analyzed patients with confirmed bladder cancer. Demographic data, type of spina bifida, functional level, mode of bladder management, and risk factors for bladder cancer were compared between patients who developed bladder cancer and the rest of patients from the Clinic using the exact Fisher's test. Results The study included 446 patients with spina bifida, all older than 20 years. From these, ten patients also presented a bladder cancer at a mean age of 36 years (range 27-43), and with a higher proportion of mid-lumbar functional level (L3 in six out of ten patients). Eight of them were female. A wide variability of presenting symptoms was observed with locally advanced disease in nine cases. The median survival time was 4 months. Conclusions Despite the advances in surgical and medical treatments, the prognosis of bladder cancer in patients with spina bifida is still poor. Screening tools are needed to improve the outcomes.