Coronary Stents medicated and dual antiplatelet therapy: NEW RISK FACTORS FOR BLADDER CANCER?
Bladder cancer accounts for about 3% of all cancers, and in urology, is second only to prostate cancer.
For bladder cancer were identified the following risk factors: cigarette smoking , chronic exposure to aromatic amines and nitrosamines , any radiotherapy involving the pelvis, taking drugs such as cyclophosphamide and ifosfamide and infection .
Materials and methods
From 01/01/2014 to 31/12/2014 in our unit we observed 110 new cases of bladder cancer, including 11 (10.1%) in patients with no known risk factor, but that they had been subjected in the year previous cardiac procedure (PTCA) with stent and dual antiplatelet therapy.
The drug used was : the everolimus.
Our patients were divided as follows: 6 males, 4 females aged between 61 and 82 aa.
These patients had undergone PTCA in a single vessel coronary stent, ischemic heart disease by dysmetabolism (hypercholesterolemia and hypertriglyceridemia), in 2013 none of these was diabetic, never smoked and no exposure to environmental risk factors for bladder cancer .
urologic symptom presentation: hematuria
Cystoscopy: all cases showed a single papillary neoformation (size 1.5 to 2.5 cm), pedunculated in small planting base
underwent TURBT, the histological in all patients was: pTa G1 / G2, that only forms noninfiltrating.
To date none of these patients had recurrences
The drugs slow release of coronary stents have been used in the past as anticancer and then hypothetically acting also antiblastic.
The Cardioaspirin, often associated in these patients, demonstrated in randomized trials also a protective action towards the development of bladder tumors.
So how to interpret this particular incidence in our series:
– A mere coincidence?
– A slatentizzazione neoplasia not yet expressed?
The paucity of cases does not allow us to make a final judgment. Uulteriori studies are needed and larger series to clarify the doubts.