Prediction of locally advanced bladder tumor using preoperative clinical parameters.

Autor: Warli SM; Department of Surgery, Division of Urology, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia.; Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia., Prapiska FF; Department of Surgery, Division of Urology, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia., Siregar DIS; Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia., Wijaya WS; Department of Urology, Faculty of Medicine, Universitas Indonesia - Haji Adam Malik General Hospital, Medan, Indonesia.
Jazyk: angličtina
Zdroj: Urology annals [Urol Ann] 2023 Oct-Dec; Vol. 15 (4), pp. 412-416. Date of Electronic Publication: 2023 Oct 20.
DOI: 10.4103/ua.ua_1_23
Abstrakt: Background: Staging of bladder cancer (BC) still remains a challenge. In conjunction with imaging, there is a critical need for accessible and cost-effective predictors to evaluate the existence of locally advanced disease.
Objective: Our aim was to determine the role of preoperative clinical parameters in predicting locally advanced cT3/4 and/or cN+ in BC.
Materials and Methods: Single-center data consisting of 32 patients were collected prospectively and eligible for the final analysis. The demographics data, presence of hydronephrosis, and results of renal function test (blood urea nitrogen [BUN] and serum creatinine [SCr]) were analyzed between the groups. Analysis of the receiver-operating characteristics curve was performed to determine the optimal cutoff value, sensitivity, and specificity of the preoperative clinical parameters, whereas multivariate logistic regression was used to assess the predictive analysis.
Results: According to preoperative computed tomography imaging, 17 (53.1%) out of 32 patients with BC had locally advanced disease. Preoperative hydronephrosis and renal insufficiency as indicated by BUN and SCr levels were independently associated with the presence of locally advanced disease ( P < 0.05). Multivariate analysis confirmed that the presence of preoperative hydronephrosis and higher level of BUN and SCr were the independent predictors of locally advanced BC (Odds ratio [OR] =6.6; 95% confidence interval [CI]: 1.40-31.05; P = 0.017; OR = 6.6; 95% CI: 1.40-31.05; P = 0.017; OR = 18.67; 95% CI: 3.16-110.29; P = 0.001, respectively). No further variables were statistically significant.
Conclusion: Preoperative assessment of hydronephrosis and renal insufficiency was able to predict locally advanced stage risk of BC cT3/4 and/or cN+; thus, preoperative staging might be improved. However, further studies are required to corroborate these findings.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2023 Urology Annals.)
Databáze: MEDLINE
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