Prognostic value of pretreatment inflammatory markers in variant histologies of the bladder: is inflammation linked to survival after radical cystectomy?

Rodler, Severin; Büchner, Alexander; Ledderose, Stephan; Eismann, Lennert; Volz, Yannic; Pfitzinger, Paulo; Kretschmer, Alexander; Schulz, Gerald Bastian; Karl, Alexander; Schlenker, Boris; Stief, Christian G.; Jokisch, Friedrich

doi:10.1007/s00345-020-03482-8

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…In the setting of MIBC, CRP has been used in outcome measures in the peri-cystectomy period. Elevated CRP prior to cystectomy predicts primary tumor stage, positive resection margins, and lymph node metastases (5,(16)(17)(18). Combining CRP with albumin [CRP-albumin ratio (CAR)] as a measure of preoperative nutritional status, can also predict survival outcomes after radical cystectomy (38).…”

Section: Crp In Bladder Cancermentioning

confidence: 99%

“…Combining CRP with albumin [CRP-albumin ratio (CAR)] as a measure of preoperative nutritional status, can also predict survival outcomes after radical cystectomy (38). Pre-operative CRP alone is also predictive of CSS in MIBC (5,18). When comparing patients with above and below average CRP levels, patients with above average CRP levels have a median CSS between 51 and 60 months shorter than those with average CRP (5,17).…”

Section: Crp In Bladder Cancermentioning

confidence: 99%

“…When comparing patients with above and below average CRP levels, patients with above average CRP levels have a median CSS between 51 and 60 months shorter than those with average CRP (5,17). Pre-cystectomy CRP is also predictive of OS (5,17,18). In a study of 240 patients undergoing radical cystectomy for bladder cancer, a new outcome prediction model was validated, called the TNR-C score.…”

Section: Crp In Bladder Cancermentioning

confidence: 99%

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The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

et al. 2021

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C-Reactive Protein (CRP) is associated with diverse outcomes in patients with, or suspected to have, genitourinary malignancies. CRP levels have been shown to be associated with the probability of a prostate cancer diagnosis in patients with elevated PSA, the probability of biochemical recurrence following definitive treatment for localized prostate cancer, and decreased overall survival for patients with advanced disease. In patients with bladder and kidney cancers, CRP levels have been associated with disease progression, stage, and cancer-specific survival. Despite the abundance of correlative studies, the relationship between CRP levels and genitourinary cancer pathogenesis is not clearly understood. Here, we review the evidence for CRP as a biomarker in genitourinary (GU) cancers, with specific focus on potential clinical applications.

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Section: Crp In Bladder Cancermentioning

confidence: 99%

Section: Crp In Bladder Cancermentioning

confidence: 99%

Section: Crp In Bladder Cancermentioning

confidence: 99%

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The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

et al. 2021

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“…Several prognostic factors were studied in bladder cancer patients undergoing curative therapy [23, 24]. However, in our cohort, these parameters did not correlate with prognosis, which might be explained both by the limited number of patients and palliative setting.…”

Section: Discussionmentioning

confidence: 71%

Clinical Implication of Borderline CT-Morphological Metastatic Spread in Bladder Cancer: What You See Is Not Always What You Got

et al. 2022

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Introduction: Palliative radical cystectomy (pRC) may be offered to selected bladder cancer (BC) patients with grievous local symptoms. However, there is only scarce information on perioperative complications and prognosis, especially in the case of metastatic spread. We intended to analyze morbidity and oncological outcome in this patient subgroup. Materials: Patients undergoing pRC because of BC with radiologic evidence of metastases were included in this retrospective study. Perioperative adverse events (AEs) were graded by the Clavien-Dindo Classification system. All patients underwent CT-based surveillance, and questionnaires were sent for survival follow-up in predefined intervals. Oncological outcome and predictive markers were assessed in univariate and multivariate analyses, using log-rank tests and Cox-regression analyses. Results: Between 2004 and 2016, 77 patients were identified. Median age at surgery was 70 years (IQR 66–77) and the median follow-up time was 12 months (IQR 4–44). Preoperative staging revealed pulmonary, hepatic, bone, peritoneal, and various other metastasis in 46/77 (60%), 14/77 (18%), 11/77 (14%), 5/77 (7%), and 11/77 (14%) cases, respectively. Most frequently observed symptoms at the time of pRC were severe gross hematuria (n = 41) and intense pain (n = 11). Most AEs were of minor grade (83%). The median length of stay was 20 days. Median CSS was 13 months with a 5-year CSS of 34%. Intriguingly and unsuspectedly, preoperatively suspicious lung lesions were confirmed during surveillance only in 33%, respectively. In multivariate analysis, intraoperative blood transfusions (HR = 2.25, 95% CI: 1.09–4.63, p = 0.028) were significantly associated with decreased CSS. The best outcome was observed in patients with only subpleural metastases (CSS 80 months, p = 0.039) and normal CRP- and Hb values. Conclusion: pRC can be performed with acceptable perioperative morbidity and mortality. Pulmonary lesions seem to have a risk of false-positive results and should be biopsied in all uncertain cases. Localization of lung metastases together with preoperative CRP- and Hb levels seem to play a prognostic role.

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“…Non-urothelial and pure histological variants include squamous cell carcinoma (SCC), glandular variant, neuroendocrine carcinoma, and adenocarcinoma (AC) [ 5 ]. Although survival of most variant histologies is not statistically different from pure UC [ 7 ], neuroendocrine, signet ring cell and spindle cell tumors reveal a poor prognosis [ 8 ]. However, variant histologies are often diagnosed at more advanced stages than UC and cohorts published in the literature are often small [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Accuracy and prognostic value of radiological lymph node features in variant histologies of bladder cancer

et al. 2022

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Purpose To provide first evidence of lymph node (LN) staging using CT scan and its prognostic value in variant histologies of bladder cancer. This knowledge may optimize patient management with variant histologies based on CT morphological findings. Methods Preoperative CT scans of patients with variant histologies who underwent RC between 2004 and 2019 were reanalyzed by two independent radiologists in a blinded review process. Specificity, sensitivity, and accuracy for LN staging as well as LN characteristics were evaluated. Correlation with survival was investigated by Kaplan–Meier method, log-rank test and multivariate analysis. Results 1361 patients with primary tumor of the bladder underwent RC, of which 163 (12%) patients revealed variant histologies. 65 (47.8%) patients have shown an urothelial variant (UV) and 71 (52.2%) a non-urothelial variant (NUV). LN metastases were found in 18 (27.7%) patients with UV and 21 (29.6%) patients with NUV. The accuracy to detect LN metastasis for all variant histologies was 62% with a sensitivity of 46% and a specificity of 70%. Subgroups of UV and NUV revealed an accuracy of 67% and 57%. An increased number of regional LN (HR 2.8; 1.34–6.18) and the loss of fatty hilum (HR 0.36, 0.17–0.76) were prognostic parameters. In multivariate analysis, a fatty hilum (HR 0.313, 0.104–0.945) and the presence of lymph node metastases (HR 2.866, 1.140–7.207) were prognostic. Conclusion This first study on CT morphological behavior of variant histologies revealed an accuracy of UV and NUV comparable to UC with low specificity for all variant histologies. CT scan prior RC should be interpreted in regard to histological subtypes.

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Prognostic value of pretreatment inflammatory markers in variant histologies of the bladder: is inflammation linked to survival after radical cystectomy?

Cited by 13 publications

References 24 publications

The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers

Clinical Implication of Borderline CT-Morphological Metastatic Spread in Bladder Cancer: What You See Is Not Always What You Got

Accuracy and prognostic value of radiological lymph node features in variant histologies of bladder cancer

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