Preoperative anemia is associated with adverse outcome in patients with urothelial carcinoma of the bladder following radical cystectomy

Gierth, Michael; Mayr, Roman; Aziz, Atiqullah; Krieger, Silke; Wullich, Bernd; Pycha, Armin; Lodde, Michele; Salvadori, Ugo; Bründl, Johannes; Fritsche, Hans Martin; Hofstädter, Ferdinand; Pawlik, Michael; Otto, Wolfgang; May, Matthias; Burger, Maximilian; Denzinger, Stefan

doi:10.1007/s00432-015-1957-7

Cited by 42 publications

(25 citation statements)

References 29 publications

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“…A meta-analysis (33) performed in 2014 highlights the role of C-reactive protein in the outcome of urological neoplasms with a negative impact on RFS and OS. In Gierth et al's (34) 2015 study, the investigators reported that preoperative anemia in patients with BC who underwent RC worsened the prognosis for the outcome of the disease. Limitations of this study include its retrospective nature; however, we followed patients for almost 10 years after TURBT.…”

Section: Fig 3 Overall Survival Estimates Of 54 Patients With Pta Bmentioning

confidence: 99%

The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

Martha

Bălan

Porav-Hodade

et al. 2020

Revista Romana De Medicina De Laborator

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Introduction:The peritumoral inflammatory reaction has a substantial importance in the oncologic outcome of bladder cancer (BC). One biomarker proven to be practical and accessible is the NLR (neutrophil-to-lymphocyte ratio) for high risk non-muscle invasive bladder cancer (NMIBC). The aim of the study was to investigate the role of NLR as a prognostic biomarker for disease recurrence, progression and survival of p Ta (pathological assesment of the primary tumor) NMIBC. Material and Methods: In our retrospective study we included 54 patients with pTa NMIBC from a total of 235 patients who underwent transurethral resection of bladder tumor (TURBT) during two consecutive years: January 2007 -December 2008]. Criteria for inclusion were: primary tumor, low-grade, with NLR available at 2 weeks prior to TURBT. NLR was considered altered if higher than 3. Results: The median age of the patients included was 63 years ). Most of the patients had NLR<3 (37 patients). Median EORTC (European Organization of Research and Treatment of Cancer) Recurrence Score was 4 (IQR 1-6), while EORTC Progression Score was 3 (IQR 0-6), respectively. Recurrence occurred in 8 out of 54 (14.81 %) patients and progression was identified in 2 out of 54 (3.70 %) patients with muscle-invasive BC during follow-up. NLR>3 was not associated with clinical and pathological factors. In multivariable Cox regression analyses NLR as a continuous variable was an independent predictive factor for recurrence. Recurrence-free survival (RFS) Kaplan-Meier analysis did not show a statistical significance between NLR groups: 82.67% vs. 64.12%, p=0.26. Kaplan-Meier analysis showed a lower Progression-free survival (PFS) in the NLR>3 group: 94.12% vs. 100%, p=0.04. During follow-up (106 months) 18 patients deceased with

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Section: Fig 3 Overall Survival Estimates Of 54 Patients With Pta Bmentioning

confidence: 99%

The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

Martha

Bălan

Porav-Hodade

et al. 2020

Revista Romana De Medicina De Laborator

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“…In one study of 684 patients undergoing radical cystectomy, preoperative anemia was found to be an independent predictor of disease recurrence, cancer-specific mortality, and all-cause mortality [57]. Of note, this study showed that although perioperative blood transfusion significantly increased all-cause mortality independent of preoperative anemia, those with preoperative anemia who received perioperative blood transfusion had no significant difference in outcome measures.…”

Section: Preoperative Interventionmentioning

confidence: 82%

“…Of note, this study showed that although perioperative blood transfusion significantly increased all-cause mortality independent of preoperative anemia, those with preoperative anemia who received perioperative blood transfusion had no significant difference in outcome measures. The authors suggest that correction of preoperative anemia may have a survival benefit irrespective of reducing transfusion rate [57]. Preoperative anemia has also been found to be an independent predictor of cancer-specific mortality for patients undergoing radical nephrectomy [48] and nephroureterectomy [49] .…”

Section: Preoperative Interventionmentioning

confidence: 99%

“…Preoperative anemia has also been found to be an independent predictor of cancer-specific mortality for patients undergoing radical nephrectomy [48] and nephroureterectomy [49] . These studies raise the possibility that the presence of preoperative anemia could be an important risk stratification tool for major urological surgery [48, 49, 57]. However, once the effect of its association with disease severity and other patient risk factors are accounted for, preoperative anemia in itself, is a relatively weak independent risk factor for poor surgical outcome [58].…”

Section: Preoperative Interventionmentioning

confidence: 99%

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The Preoperative Assessment and Optimization of Patients Undergoing Major Urological Surgery

2017

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Purpose of ReviewImproving patient outcomes from major urological surgery requires not only advancement in surgical technique and technology, but also the practice of patient-centered, multidisciplinary, and integrated medical care of these patients from the moment of contemplation of surgery until full recovery. This review examines the evidence for recent developments in preoperative assessment and optimization that is of relevance to major urological surgery.Recent FindingsCurrent perioperative medicine recommendations aim to improve the short-term safety and long-term effectiveness of surgical treatments by the delivery of multidisciplinary integrated medical care. New strategies to deliver this aim include preoperative risk stratification using a frailty index and cardiopulmonary exercise testing for patients undergoing intra-abdominal surgery (including radical cystectomy), preoperative management of iron deficiency and anemia, and preoperative exercise intervention.SummaryProof of the utility and validity for improving surgical outcomes through advances in preoperative care is still evolving. Evidence-based developments in this field are likely to benefit patients undergoing major urological surgery, but further research targeted at high-risk patients undergoing specific urological operations is required.

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“…Various predictive models have been widely studied to reduce BC-related death (Lammers et al, 2015). Previous studies have attempted to identify variables that have prognostic value in patients with T2 to T4 stage BC undergoing cystectomy, one of which was pretreatment hemoglobin (Hb) level (Thrasher et al, 1994;Gierth et al, 2015;Milojevic et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Predictive Effect of Preoperative Anemia on Long-Term Survival Outcomes with Non-Muscle Invasive Bladder Cancer

Çelik¹,

Akand²,

Keskın³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Background: Anemia is the most common hematologic abnormality in bladder cancer (BC) patients. We evaluated the impact of preoperative anemia on oncologic outcomes in BC undergoing transurethral resection of a bladder tumor (TURBT) for the first time diagnosis. Materials and Methods: We retrospectively evaluated the data collected from 639 patients who underwent TURBT between January 2006 and September 2014 in our department. Of these patients, 320 qualified for inclusion in the study. The primary efficacy endpoint was the effect of preoperative anemia status on cancer-specific and overall survival. Independent t-test and chi-square analyses were performed to assess the effects of anemia on oncologic outcomes. Survival was estimated by using the Kaplan-Meier test. Results: There were 118 (36.9%) and 202 (63.1%) patients in the anemia (Group-1) and non-anemia groups (Group-2), respectively. The median follow-up duration was 68 months. Anemia was associated with decreased overall survival (p<0.001). Comparison between cancer-specific survival of two groups did not show any statistically significant difference (p=0.17). Conclusions: Preoperative anemia status of BC patients according to World Health Organization classification is associated with decreased overall survival, but not with cancer-specific survival. We think that preoperative hemoglobin levels should be considered in patient counseling and decision-making for additional therapy.

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Preoperative anemia is associated with adverse outcome in patients with urothelial carcinoma of the bladder following radical cystectomy

Cited by 42 publications

References 29 publications

The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

The Preoperative Assessment and Optimization of Patients Undergoing Major Urological Surgery

Predictive Effect of Preoperative Anemia on Long-Term Survival Outcomes with Non-Muscle Invasive Bladder Cancer

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