Preoperative risk stratification models after radical cystectomy for bladder cancer: A multi-center study.

Autor: Yamane H; Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan., Morizane S; Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan., Honda M; Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan., Muraoka K; Department of Urology, Tottori Prefectural Central Hospital, Tottori, Tottori, Japan., Oono H; Department of Urology, Japanese Red Cross Matsue Hospital, Matsue, Shimane, Japan., Isoyama T; Department of Urology, Yonago Medical Center, Yonago, Tottori, Japan., Ono K; Department of Urology, Japanese Red Cross Tottori Hospital, Tottori, Tottori, Japan., Sejima T; Department of Urology, Matsue City Hospital, Matsue, Shimane, Japan., Kadowaki H; Department of Urology, Sanin Rosai Hospital, Yonago, Tottori, Japan., Takenaka A; Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan.
Jazyk: angličtina
Zdroj: International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2024 Nov; Vol. 31 (11), pp. 1278-1287. Date of Electronic Publication: 2024 Aug 14.
DOI: 10.1111/iju.15560
Abstrakt: Objective: We investigated preoperative patient factors associated with prognosis in 263 bladder cancer (BC) patients undergoing radical cystectomy (RC). We also developed new risk stratification models for prognosis.
Methods: This retrospective study included patients treated at Tottori University Hospital and affiliated hospitals between January 2010 and December 2019. The relationship between preoperative patient factors and overall recurrence-free and cancer-specific survival (CSS) was analyzed. The modified Glasgow prognosis score (mGPS) was calculated using serum albumin and C-reactive protein (CRP) levels. Statistical analyses included the log-rank test and Cox proportional hazards regression.
Results: Eastern Cooperative Oncology Group performance status (ECOG-PS), mGPS, and clinical tumor stage independently predicted CSS in multivariate analysis. A new risk stratification model included ECOG-PS ≥2, clinical tumor stage ≥3, serum albumin <3.5 g/dL, and serum CRP >0.5 mg/dL. Risk groups were defined as 0 factors (low risk), 1-2 factors (intermediate risk), and 3-4 factors (high risk). High-risk patients showed significantly poorer 3-year cancer-free survival: 86.9% (low risk), 76.7% (intermediate risk), and 50.0% (high risk).
Conclusions: ECOG-PS, clinical tumor stage, and mGPS are predictive of poor cancer-free survival post-RC for BC. Our model offers the potential for prognostic prediction in these patients.
(© 2024 The Japanese Urological Association.)
Databáze: MEDLINE
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