Preoperative hydronephrosis as an indicator of survival after radical cystectomy

Chapman, Darren M.; Pohar, Kamal S.; Gong, Michael C.; Bahnson, Robert R.

doi:10.1016/j.urolonc.2008.06.001

Cited by 29 publications

(23 citation statements)

References 16 publications

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“…These predictors were some characteristics of the patient (sex, age, indexes of comorbidity) and some indicators of the local extent of cancer (hydronephrosis, T stage) with a confirmed relationship with the risk of complications, as shown by some previous studies. 18,19 It was confirmed that RC is burdened by a high rate of complications, even in a modern era and at a referral center, with an overall 90-day complication rate >50%, a rate of severe (Clavien classification !3) complications >10%, and a perioperative mortality at approximately 2%. Some retrospective studies reported lower rates, 20 and recent studies that systematically reported complications showed very similar rates, 7,21 confirming that otherwise the occurrence of complications are not adequately perceived and generally underestimated.…”

Section: Alessandro Antonelli Et Almentioning

confidence: 96%

Comparison of Perioperative Morbidity of Radical Cystectomy With Neobladder Versus Ileal Conduit: A Matched Pair Analysis of 170 Patients

Antonelli

Belotti

Cristinelli

et al. 2016

Clinical Genitourinary Cancer

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Section: Alessandro Antonelli Et Almentioning

confidence: 96%

Comparison of Perioperative Morbidity of Radical Cystectomy With Neobladder Versus Ileal Conduit: A Matched Pair Analysis of 170 Patients

Antonelli

Belotti

Cristinelli

et al. 2016

Clinical Genitourinary Cancer

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“…Many patients with bladder cancer were found to have hydronephrosis due to ureteral orifice obstruction by tumor. Although pathologic stage is regarded as crucial prognostic characteristic after radical cystectomy, the prognostic role of hydronephrosis has been investigated with conflicting results . To the best our knowledge, the relationship between the presence of preoperative hydronephrosis and prognosis after RARC has not yet been investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Although pathologic stage is regarded as crucial prognostic characteristic after radical cystectomy, the prognostic role of hydronephrosis has been investigated with conflicting results. [19][20][21][22] To the best our knowledge, the relationship between the presence of preoperative hydronephrosis and F I G U R E 1 Receiver operating characteristic (ROC) curves for overall survival prognosis after RARC has not yet been investigated. In our study, we found that preoperative hydronephrosis was significantly associated with 1-year mortality after RARC according to univariate cox regression.…”

Section: Discussionmentioning

confidence: 99%

Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy

Zhu

Wang

et al. 2019

Cancer Medicine

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Background Early identification of early death for bladder cancer patients undergoing radical cystectomy based on the laboratory findings at the time of diagnosis could improve the overall survival. The study aimed to explore preoperative factors associated with higher risk of early death (within 1 year after surgery) for bladder cancer patients. Methods A total of 186 bladder cancer patients who underwent robot‐assisted radical cystectomy (RARC) were identified between October 2014 and May 2017. The probability of dying within 1 year after RARC was defined as the end point “early death.” Predictive factors including clinical features and laboratory findings at diagnosis were retrospectively collected. Results Median follow‐up time after RARC was 20.6 months (1.2‐43.7 months). Fifty‐one patients (27.4%) died during follow‐up and 31 within 1 year from surgery (1‐year mortality rate: 16.7%). All potentially prognostic factors were assessed on univariate analyses, which revealed the following factors as being associated with higher risk of early death within 1 year after RARC: older age ( P = 0.004), advanced clinical stage ( P = 0.005), presence of hydronephrosis ( P = 0.021), higher fibrinogen ( P = 0.007), higher PLR ( P = 0.031), and lower PNI ( P = 0.016). In a multivariate Cox proportional hazard regression model analysis, age >60 years (HR = 7.303, 95% CI 1.734‐30.764; P = 0.007) and fibrinogen ≥3.295 g/L (HR = 2.396, 95% CI 1.138‐5.045; P = 0.007) at diagnosis were independent prognostic factors of early death after RARC. Conclusion Age and preoperative elevated plasma fibrinogen level were independent predictors for 1‐year mortality after RARC. We believe that plasma fibrinogen levels may become a useful biomarker, which may help guide the treatment decision‐making process for patients with bladder cancer.

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“…Several risk factors either leading to pathological upstaging in BCa patients after RCX and PLND or compromising recurrence-free and overall survival (OS) rates have been established. These include presence of preoperative hydronephrosis, evidence of lymphovascular invasion, deep muscularis propria infiltration and non-papillary or solid tumor growth pattern in the histological specimen after transurethral resection as well as multiplicity of tumors and age of patients [7,8,9,10,11]. Clinical nomograms incorporating these factors have been proposed to pre-therapeutically identify patients in whom upstaging is likely and who might benefit from neoadjuvant regimens [10,11].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of <sup>11</sup>C-Choline PET/CT and CT for Predicting Survival of Bladder Cancer Patients Treated with Radical Cystectomy

Maurer

Horn²,

Souvatzoglou³

et al. 2014

Urol Int

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Background: In patients with bladder cancer (BCa) preoperative staging with ¹¹C-choline positron emission tomography-computed tomography (PET/CT) could be used to derive prognostic information and hence stratify patients preoperatively with respect to disease management. Methods: From June 2004 to May 2007, 44 patients with localized BCa were staged with ¹¹C-choline PET/CT before radical cystectomy. The results of imaging were correlated to overall survival (OS) and cumulative incidence of cancer-specific death (CSD). Results: There was no statistically significant difference in OS and CSD between the patient groups when stratified for organ-confined versus non-organ-confined disease or lymph node involvement defined by either ¹¹C-choline PET/CT (OS: p = 0.262, hazard ratio [HR] = 1.60; p = 0.527, HR = 0.76; CSD: p = 0.144, HR = 2.25; p = 0.976, HR = 0.98) or CT (OS: p = 0.518, HR = 1.34; p = 0.228, HR = 1.67; CSD: p = 0.323, HR = 1.90; p = 0.136, HR = 2.38). The limitation of this study is the small number of included patients. Conclusion: In our prospective trial neither CT nor ¹¹C-choline PET/CT were able to sufficiently predict OS or CSD in BCa patients treated with radical cystectomy albeit trends and moderately increased HRs could be demonstrated without significant differences between CT or ¹¹C-choline PET/CT. However, these trends might prove statistically significant in bigger patient cohorts. Therefore initial transsectional imaging might be of clinical relevance in respect to prognosis and could play a role in the counseling of BCa patients.

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Preoperative hydronephrosis as an indicator of survival after radical cystectomy

Cited by 29 publications

References 16 publications

Comparison of Perioperative Morbidity of Radical Cystectomy With Neobladder Versus Ileal Conduit: A Matched Pair Analysis of 170 Patients

Comparison of Perioperative Morbidity of Radical Cystectomy With Neobladder Versus Ileal Conduit: A Matched Pair Analysis of 170 Patients

Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy

Prognostic Value of <sup>11</sup>C-Choline PET/CT and CT for Predicting Survival of Bladder Cancer Patients Treated with Radical Cystectomy

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