TY - JOUR AU - Maneesuwansin,, Saran AU - Suk-ouichai, Chalairat AU - Ramart, Patkawat AU - Jitpraphai, Siros AU - Phinthusophon, Kittipong AU - Chotikawanich, Ekkarin AU - Amornvesukit, Teerapon AU - Taweemonkongsap, Tawatchai AU - Chaiyaprasithi, Bansithi AU - Leewansangtong, Sunai AU - Srinualnad, Sittiporn AU - Nualyong, Chaiyong PY - 2019/02/15 Y2 - 2024/03/29 TI - Administration of Renin-Angiotensin System Inhibitor Affects Tumor Recurrence and Progression in Non-Muscle Invasive Bladder Cancer Patients JF - Siriraj Medical Journal JA - Siriraj Med J VL - 71 IS - 1 SE - Original Article DO - 10.33192/Smj.2019.06 UR - https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/172771 SP - 31-37 AB - <p><strong>Objective:</strong> To evaluate the effects of renin-angiotensin system inhibitors (RASIs) on tumor-recurrence and diseaseprogression<br>in non-muscle invasive bladder cancer (NMIBC) patients.<br><strong>Methods:</strong> From 2006-2015, 348 NMIBC patients at Siriraj Hospital were recruited for this study. Tumor-recurrence<br>was identified after the transurethral resection of bladder cancer (TUR-BT) and pathological confirmation of NMIBC,<br>while stage-progression was defined as muscularis-propria invasion after pathological review or metastases. Cox<br>proportional hazards models were used to assess the recurrence-free survival (RFS) and progression-free survival<br>(PFS) rates.<br><strong>Results:</strong> Of the 348 patients, 86 (24.7%) received RASIs at the first TUR-BT. The median age was 68 years, and it<br>was significantly older for the RASI cohort. No differences in the tumor characteristics of the groups were found.<br>The median follow-up periods for tumor-recurrence and stage-progression were 2.3 and 3.7 years, respectively.<br>Forty percent of the patients experienced tumor-recurrence, with the no-RASI cohort experiencing a significantly<br>higher tumor-recurrence rate (46% versus 22%, p&lt;0.001). The 5-year RFS rates were 54% and 78% for the no-RASI<br>and RASI cohorts, respectively (p=0.001). Stage-progression was observed in 6% of the patients. The 5-year PFS<br>rates were 87% and 97% for the no-RASI and RASI cohorts, respectively. On univariate and multivariate analyses,<br>a tumor size ≥3 cm and tumor multifocality were associated with recurrent bladder cancer (p&lt;0.02). On the other<br>hand, the administration of RASIs was associated with a reduced recurrence (p≤0.002).<br><strong>Conclusion:</strong> Our study suggests that RASI administration might be a potential factor to prevent bladder cancer<br>recurrence. Further study is needed to evaluate the effects of RASIs.</p> ER -