Predictive Value of Duration and Frequency of Macroscopic Haematuria for Stage, Prognosis and Recurrence in Bladder Cancer Patients

Objective: We aimed to investigate the predictive value of duration and frequency of macroscopic haematuria for the stage, prognosis and recurrence rates in primary bladder cancer. Materials and Methods: We retrospectively reviewed the data of our patients diagnosed with primary bladder cancers during 2000-2014. Patients with history of macroscopic haematuria were included. Their haematuria duration and frequency and stage and grade of bladder cancer, recurrence rates, time until recurrence, time until progression and pre-operative use of anticoagulants were evaluated. Results: A total of 331 patients comprising 276 males (83%) and 55 females (16%) were included in the study. The mean age of the patients was 64.0 +/- 11.8 (28-93) years. The average haematuria duration was 18.5 +/- 33.5 (0-260) months. There were 173 (52%), 106 (32%) and 52 (15.7%) patients with cancer stages of Ta, T1 and T2, respectively. The average follow-up time was 54.0 +/- 41.8 (1-268) months. The frequency of haematuria was significantly higher in patients with muscle-invasive bladder cancers than in those with superficial bladder cancers (p=0.010). Similarly, patients with tumour diameter >3 cm reported significantly higher frequency of haematuria than in those with tumour diameter <3 cm (p=0.045). Five patients exclude from study because they did not attend their follow-up. During follow-up recurrences were seen in 89 (32.3%) out of 326 patients, while 237 (72.7%) patients did have any recurrences. Disease progression was reported in 28 (8.5%) patients. The average time periods until recurrence and progression were 25.8 +/- 34.7 months and 27.1 +/- 34.9 (1-144) months, respectively. Conclusion: We found a significant difference between the frequency of haematuria in patients with muscle-invasive cancers and those with superficial cancers. Also, we found a negative correlation between smoking and the time until recurrence in patients with macroscopic haematuria. No significant relationships were observed between the duration of haematuria and cancer recurrence rates and prognosis.