Urothelial carcinoma of the upper urinary tract: preoperative pyuria is not correlated with bladder cancer recurrence and survival

Milojević, Bogomir; Džamić, Zoran; Bojanic, Nebojsa; Durutović, Otaš; Janicic, Aleksandar; Kajmaković, Boris; Milojevic, Isidora Grozdic; Bumbaširević, Uroš; Grubor, Nikola; Grujičić, Sandra Šipetić

doi:10.1007/s11255-019-02133-1

Cited by 7 publications

(9 citation statements)

References 17 publications

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“…Also, they used a retrospective analysis of a relatively small study sample (97 patients). Milojevic et al [24] recently published a study indicating that preoperative pyuria is not associated with bladder cancer recurrence and survival. In that study, multivariable analysis showed that preoperative pyuria was not significantly associated with IVR and CSS (p=0.56 and 0.79).…”

Section: Discussionmentioning

confidence: 99%

Preoperative sterile pyuria as a prognosticbiomarker for intravesical recurrence in upperurinary tract urothelial carcinoma

et al. 2020

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Purpose: To evaluate if preoperative sterile pyuria can be a prognostic factor for intravesical recurrence (IVR) and overall survival (OS) in patients with upper tract urothelial carcinoma (UTUC) undergoing surgery. Materials and Methods: We retrospectively reviewed the medical records of patients who were diagnosed with UTUC from October 2003 to December 2016 at Korea University Medical Center. Sterile pyuria was defined as urine containing five or more white blood cells per high-power field in the absence of bacteria in urine culture. We used a stepwise multivariable Cox proportional hazards model to assess the independent effects of the prognostic factors for IVR and OS. Results: We investigated a total of 176 patients who were diagnosed with UTUC. Among them, 91 (51.7%) patients had preoperative sterile pyuria. There were no significant differences in the baseline characteristics between the pyuria and non-pyuria groups concerning tumor grade, T stage, tumor multiplicity, and recurrence history. However, there was a significant difference in the IVR between the two groups. In the multivariable analysis, preoperative sterile pyuria, diabetes mellitus, high-grade tumor, and lymphovascular invasion were revealed as independent risk factors for IVR, and only lymphovascular invasion was identified as an independent risk factor for OS. Conclusions: Preoperative sterile pyuria is significantly associated with IVR in patients with UTUC undergoing surgery, but it is not associated with OS. Furthermore, diabetes mellitus, high-grade tumor, and lymphovascular invasion are also independent prognostic factors for these patients.

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Section: Discussionmentioning

confidence: 99%

Preoperative sterile pyuria as a prognosticbiomarker for intravesical recurrence in upperurinary tract urothelial carcinoma

et al. 2020

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“…A considerable literature review indicates that pre-treatment hematologic abnormalities and changes in serum inflammatory markers may have important prognostic implications in urothelial cancer, with platelet count being one of them. [7][8][9][10][11] Different preoperative blood parameters, such as CRP and platelet/lymphocyte ratio, have been identified as prognostic factors of survival after RC. 4 Preoperative thrombocytosis (PTC) has been observed as a prognostic factor in various carcinoma, including lung cancer, glioblastoma, renal cancer, and several gastrointestinal tumors.…”

Section: Introductionmentioning

confidence: 99%

“…A considerable literature review indicates that pre‐treatment hematologic abnormalities and changes in serum inflammatory markers may have important prognostic implications in urothelial cancer, with platelet count being one of them 7–11 . Different preoperative blood parameters, such as CRP and platelet/lymphocyte ratio, have been identified as prognostic factors of survival after RC 4 …”

Section: Introductionmentioning

confidence: 99%

Diagnostic and prognostic impact of preoperative thrombocytosis in muscle invasive bladder cancer: Any role in clinical practice?

Sretenovic,

Bojanic,

Grozdic Milojevic

et al. 2023

J of Clinical Ultrasound

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BackgroundSince earlier research suggested a link between preoperative thrombocytosis and poor oncological outcomes in several cancers, the significance of platelet count abnormalities in bladder carcinoma (BC) demands for further investigation.ObjectiveTo assess the prognostic value of preoperative thrombocytosis (PTC) on survival in patients with bladder carcinoma treated by radical cystectomy (RC).Patients and MethodsAnalytical cohort comprised a single‐center series of 299 patients who underwent RC for bladder carcinoma was evaluated. A platelet count beyond the threshold of 400 × 109/L was considered thrombocytosis. Along with the Kaplan–Meier survival probability, cox proportional hazard regression models were used.ResultsTwenty‐eight (9.4%) patients had preoperative thrombocytosis. PTC was associated with gender, tumor stage, tumor grade, lymphovascular invasion, hydronephrosis, anemia (p < 0.001), and hypoalbuminemia (p < 0.001). Preoperative thrombocytosis was strongly linked to worse overall survival (OS) (p = 0.002), and cancer specific survival (CSS) (p = 0.004), according to the Kaplan–Meier method. Throughout the follow‐up, a total of 198 (66.2%) patients died, including 170 (56.9%) from BC. For this study population 5‐year CSS was 45.8%. Preoperative thrombocytosis was not independently associated with OS (HR 1.168; 95% CI 0.740–1.844; p = 0.504) or CSS (HR 1.060; 95% CI 0.649–1.730; p = 0.816) in multivariate Cox regression analysis. Only tumor stage (HR 2.558; 95% CI 1.675–3.908; p < 0.001), hydronephrosis (HR 1.614; 95% CI 1.173–2.221; p = 0.003), lymph node metastasis (HR 1.555; 95% CI 1.076–2‐2.248; p = 0.019), anemia (HR 1.454; 95% CI 1.034–2.046; p = 0.032) and ASA grade (HR 1.375; 95% CI 1.006–1.879; p = 0.046) were independently associated with CSS.ConclusionsIn a single‐center study of consecutive patients who underwent radical cystectomy for bladder cancer, preoperative thrombocytosis was unable to predict outcomes.

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“…to have predictive relevance in patients with BC in a recent study. [7][8][9][10][11][12] The most frequently sampled liver enzymes in laboratory settings are alanine aminotransferase (ALT) and aspartate aminotransferase AST. The De Ritis ratio, named after De Ritis who first defined the ratio of serum activities of AST to ALT, is a well-recognized concept (AST/ALT).…”

Section: Introductionmentioning

confidence: 99%

“…Since the course of the illness differs, it is essential to pinpoint risk factors linked to poor survival to enhance the selection of adjuvant therapy. Currently, the bulk of these indicators are pathological characteristics, including lymphovascular invasion (LVI), tumor stage, grade, lymph node status, concurrent carcinoma in situ (CIS), variant histology, and surgical margin status 7–12 . Sadly, the accuracy of outcome prediction using these parameters is still subpar, most likely because they do not fully exploit the physiologic potential of host‐tumor interactions.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of preoperative De Ritis ratio on oncological outcomes in patients with muscle‐invasive bladder cancer

Sretenovic,

Lisicic,

Bulat

et al. 2023

Journal of Surgical Oncology

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ObjectiveWe aimed to assess the prognostic value of De Ritis ratio on oncological outcomes in patients suffering from urothelial bladder cancer and undergoing radical cystectomy (RC).Patients and MethodsAnalytical cohort comprised a single‐center series of 367 patients treated between January 2015 and December 2018. Patients were classified into two groups based on De Ritis ratio (<1.3 [normal] vs. ≥1.3 [high]). Along with the Kaplan‐Meier survival probability, cox proportional hazard regression models were used.ResultsA total of 299 patients were included, 60.5% of them having a De Ritis ratio of <1.3% and 39.5% with a De Ritis ratio of ≥1.3. Preoperative increased De Ritis ratio was associated with age (p = 0.001), gender (p = 0.044), cancer‐related death (p = 0.001), overall death (p = 0.001), and tumor stage (p = 0.001). Multivariate analysis implied that preoperative De Ritis ratio was a significant independent prognosticator of overall survival (HR 0.461; 95% CI 0.335–0.633; p < 0.001) and CSS (HR 0.454; 95% CI 0.330–0.623; p < 0.001). Only tumor stage (HR 1.953; 95% CI 1. 106–3.448; p = 0.021) was independently associated with recurrence‐free survival (RFS). De Ritis ratio was not independently associated with RFS in multivariate analyses. During the follow up, a total of 198 (66.2%) patients died, including 173 (57.9%) from BC, 5‐year CSS was 45.8%.ConclusionsDe Ritis ratio is an independent prognostic factor of cancer specific and overall survival in patients treated with RC for urothelial BC. RC patients may benefit from the use of the De Ritis ratio as a valid predictive biomarker.

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Urothelial carcinoma of the upper urinary tract: preoperative pyuria is not correlated with bladder cancer recurrence and survival

Cited by 7 publications

References 17 publications

Preoperative sterile pyuria as a prognosticbiomarker for intravesical recurrence in upperurinary tract urothelial carcinoma

Preoperative sterile pyuria as a prognosticbiomarker for intravesical recurrence in upperurinary tract urothelial carcinoma

Diagnostic and prognostic impact of preoperative thrombocytosis in muscle invasive bladder cancer: Any role in clinical practice?

Prognostic value of preoperative De Ritis ratio on oncological outcomes in patients with muscle‐invasive bladder cancer

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