Prognostic value of preoperative blood-based biomarkers in upper tract urothelial carcinoma treated with nephroureterectomy: A systematic review and meta-analysis

Mori, Keiichiro; Janisch, Florian; Mostafaei, Hadi; Лысенко, И. М.; Kimura, Shoji; Egawa, Shin; Shariat, Shahrokh F.

doi:10.1016/j.urolonc.2020.01.015

Cited by 40 publications

(33 citation statements)

References 99 publications

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“…The plasma fibrinogen level has been assessed in several retrospective series of patients treated with RNU for UTUC. These results have been evaluated in a systematic review and meta-analysis that concluded significant prognostic value to predict CSM after RNU [26]. Two other reviews highlighted the role of high levels of coagulation factors, including fibrinogen, in predicting poorer OS and CSS in the broad spectrum of urological malignancies [27,28].…”

Section: Discussionmentioning

confidence: 99%

Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer

Mari

Muto

Maida

et al. 2020

Arab Journal of Urology

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Objective: To evaluate the impact of preoperative markers of systemic inflammation on complications and oncological outcomes in patients aged ≥75 years treated with radical cystectomy (RC) for urothelial bladder cancer (UBC). Patients and methods: The clinical data of 694 patients treated with open RC for UBC at our institution between January 2008 and December 2015 were retrospectively reviewed. Patients aged <75 years, with distant metastases, other-than-urothelial histological type, comorbidities that could affect the systemic inflammatory markers, and patients who received neoadjuvant chemotherapy were excluded. Multivariable regression models were built for the prediction of major postoperative surgical complications, disease recurrence, cancer-specific mortality (CSM), and overall mortality (OM). Results: The median (interquartile range [IQR]) age at surgery was 79 (75-83) years. Major postoperative surgical complications were registered in 41.9% of the patients. The 5-year overall survival, cancer-specific survival and recurrence-free survival rates were 42.4% (95% confidence interval [CI] 34.7-49.9%), 70.3% (95% CI 62.3-76.9%), and 59.8% (95% CI 52.4-66.5), respectively. At multivariable analysis, higher levels of fibrinogen and a modified Glasgow Prognostic Score (mGPS) of 1 and 2 at baseline were independently associated with higher risk of major postoperative complications and of CSM. The inclusion of mGPS and fibrinogen to a standard multivariable model for recurrence and for CSM increased discrimination from 69.4% to 73.0% and from 71.3% to 73.9%, respectively. Preoperative neutrophil-to-lymphocyte ratio of >3 was independently associated with OM (hazard ratio 1.38, 95% CI 1.01-1.77; P = 0.01). Conclusions: In a cohort of elderly patients with UBC treated with RC, fibrinogen and mGPS appeared to be the most relevant prognostic measurements and increased the accuracy of clinicopathological preoperative models to predict major postoperative complications, disease recurrence and mortality.

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Section: Discussionmentioning

confidence: 99%

Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer

Mari

Muto

Maida

et al. 2020

Arab Journal of Urology

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“…The product of the intensity score and stained area percentage was added and used as the total score. The final scores ranged from 0 to 8 and were designated low (0-4) or high (5)(6)(7)(8).…”

Section: Evaluation Of the Ihc Resultsmentioning

confidence: 99%

“…Currently available prognostic tools that utilize clinical and pathological parameters are limited for UTUC. Through the analysis of biomarkers in pathological specimens, we may strengthen the risk stratification and guide better prognostic evaluations for a more effective therapeutic strategy (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

FOXO3A Expression in Upper Tract Urothelial Carcinoma

et al. 2021

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BackgroundEpidemiological studies have reported various results regarding whether FOXO3A is related to various carcinomas. However, the prognostic significance of FOXO3A in upper tract urothelial carcinoma (UTUC) remains unclear. The purpose of this study was to validate the correlation between FOXO3A expression and oncological outcomes in UTUC.MethodsThe expression levels of FOXO3A in 107 UTUC patients were examined by immunohistochemistry (IHC). We examined the prognostic role of FOXO3A by using the Cox proportional hazard model.ResultsThe results indicated that FOXO3A expression was notably decreased in UTUC tissue compared with control tissue. Decreased expression of FOXO3A was also related to advanced pathologic stage (P = 0.026), lymph node metastasis (P = 0.040), lymphovascular invasion (P < 0.001), and adjuvant therapy (P = 0.048). In addition, UTUC patients with low FOXO3A expression had a significantly shorter survival time, including both overall survival (OS) [hazard ratio (HR) 2.382, P = 0.004] and recurrence-free survival (RFS) (HR 2.385, P = 0.004), than those with high expression. Multivariate analyses showed that FOXO3A was a significant predictor for OS (HR 2.145, P = 0.014) and RFS (HR 2.227, P = 0.010) in UTUC patients.ConclusionOur results indicate that FOXO3A may be involved in the recurrence of UTUC and that it has certain clinical value in the therapeutic targeting and prognostic evaluation of UTUC.

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“…Consequently, an increased AST is not always caused by hepatic pathology, especially if ALT is not comparably and simultaneously elevated [31,33]. It is currently hypothesized that anaerobic glycolysis, which is typical of the metabolism of cancer cells (the "Warburg effect") may explain the prognostic value of the De Ritis ratio [21][22][23][24][26][27][28][29][30]34,35]. In this context, several interactions exist between increased anaerobic glycolysis, an altered NAD+/NADH ratio in the cytoplasm, and AST, which is essential for the function of the malate-aspartate shuttle [31,[36][37][38].…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of the De Ritis Ratio for Progression-Free Survival in Patients with NET Undergoing [177Lu]Lu-DOTATOC-PRRT: A Retrospective Analysis

Ruhwedel

Rogasch

Huang

et al. 2021

Cancers

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Background: The De Ritis ratio (aspartate aminotransferase [AST]/alanine aminotransferase [ALT]) has demonstrated prognostic value in various cancer entities. We evaluated the prognostic capability of the De Ritis ratio in patients with metastatic neuroendocrine tumors (NET) undergoing peptide receptor radionuclide therapy (PRRT). Methods: Unicentric, retrospective analysis of 125 patients with NET undergoing PRRT with [177Lu]Lu-DOTATOC (female: 37%; median age: 66 years; G1+G2 NET: 95%). The prognostic value regarding progression-free survival (PFS) was analyzed with univariable and multivariable Cox regression. Prognostic accuracy was determined with Harrell’s C index and a likelihood ratio test. Results: Progression, relapse, or death after PRRT was observed in 102/125 patients. Median progression-free survival (PFS) was 15.8 months. Pancreatic or pulmonary origin, high De Ritis ratio, and high Chromogranin A (CgA) significantly predicted shorter PFS in univariable Cox. In multivariable Cox regression, only high De Ritis ratio >0.927 (HR: 1.7; p = 0.047) and high CgA >twice the upper normal limit (HR: 2.1; p = 0.005) remained independent predictors of shorter PFS. Adding the De Ritis ratio to the multivariable Cox model (age, Eastern Cooperative Oncology Group (ECOG) performance status, primary origin, CgA) significantly improved prognostic accuracy (p < 0.001). Conclusions: The De Ritis ratio is simple to obtain in clinical routine and can provide independent prognostic value for PFS in patients with NET undergoing PRRT.

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Prognostic value of preoperative blood-based biomarkers in upper tract urothelial carcinoma treated with nephroureterectomy: A systematic review and meta-analysis

Cited by 40 publications

References 99 publications

Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer

Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer

FOXO3A Expression in Upper Tract Urothelial Carcinoma

The Prognostic Value of the De Ritis Ratio for Progression-Free Survival in Patients with NET Undergoing [177Lu]Lu-DOTATOC-PRRT: A Retrospective Analysis

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