Impact of arsenic exposure on clinicopathological characteristics of bladder cancer: a comparative study between patients from an arsenic-exposed region and nonexposed reference sites
Author
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Fernández, Mario I.
Author
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Valdebenito, Patricio
Author
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Delgado, Iris
Author
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Segebre, Jorge
Author
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Chaparro, Eduardo
Author
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Fuentealba, David
Author
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Castillo, Martín
Author
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Vial, Cecilia
Author
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Barroso, Juan P.
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Ziegler, Annemarie
Author
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Bustamante, Alberto
Admission date
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2020-06-03T15:08:08Z
Available date
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2020-06-03T15:08:08Z
Publication date
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2020
Cita de ítem
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Urologic Oncology: Seminars and Original Investigations 38 (2020) 40.e1−40.e7
es_ES
Identifier
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10.1016/j.urolonc.2019.09.013
Identifier
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https://repositorio.uchile.cl/handle/2250/175181
Abstract
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Background: Beyond exposure to arsenic in drinking-water, there is few information about demographic and clinicopathological features of patients with bladder cancer living in arsenic-exposed regions. The aim of the study was to assess the impact of arsenic exposure on clinicopathological characteristics in patients with bladder cancer from a contaminated region compared to those of 2 reference areas. Methods: Data of 285 patients with bladder cancer (83 with arsenic exposure from Antofagasta and 202 controls from 2 different sites in Santiago) were obtained through personal interviews and from review of medical records. Demographic, clinicopathological parameters, and information on relevant environmental risk factors were compared with parametric and nonparametric tests as needed. Multivariable analysis was performed to identify independent predictors for high grade and muscle-invasive disease (T2-4). Results: We found no significant differences between groups regarding age at presentation (66.4 vs. 66.5 and 67.2 years; P = 0.69, for exposed vs. the 2 nonexposed groups, respectively) and female gender (28.9% vs. 29.8% and 26.2%; P = 0.84). Proportion of current smokers was significantly lower in the exposed population (10.7% vs. 38.6% and 26.9%; P < 0.001). There was a significantly higher proportion of locally advanced (10.8 vs. 1.8 and 0.7% T3/4; P = 0.002) and high-grade tumors (79.5% vs. 63.2% and 64.1%; P = 0.001) within arsenic-exposed patients. Arsenic exposure was the only significant predictor for the presence of high-grade tumors (adjusted OR: 5.10; 95%CI: 2.03-12.77) on multivariable analysis. Conclusions: Our study revealed relevant clinical differences in bladder cancer patients with a history of arsenic exposure as compared to nonexposed cases. The more aggressive phenotype associated to arsenic-related bladder cancer should be considered when designing efficient screening strategies for this high-risk population.
es_ES
Patrocinador
dc.description.sponsorship
Comisión Nacional de Investigación Científica y Tecnológica (CONICYT), CONICYT FONDECYT: 1120987.
Impact of arsenic exposure on clinicopathological characteristics of bladder cancer: a comparative study between patients from an arsenic-exposed region and nonexposed reference sites