Pre-Op Hydronephrosis Predicts Outcomes in Patients Receiving Robot-Assisted Radical Cystectomy.

Autor: Wong CH; S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Ko IC; S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Leung DK; S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China., Kang SH; Department of Urology, Korea University Anam Hospital, Seoul 02841, Republic of Korea., Kitamura K; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan., Horie S; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan., Muto S; Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan., Ohyama C; Department of Urology, Hirosaki University, Hirosaki 036-8561, Japan., Hatakeyama S; Department of Urology, Hirosaki University, Hirosaki 036-8561, Japan., Patel M; Department of Urology, The University of Sydney, Camperdown, NSW 2006, Australia., Yang CK; Department of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, China., Kijvikai K; Department of Urology, Ramathibodi Hospital, Mahidol University, Nakhon Pathom 10400, Thailand., Lee JY; Department of Urology, Catholic University of Korea, Seoul 07345, Republic of Korea., Chen HG; Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200030, China., Zhang RY; Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200030, China., Lin TX; Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China., Lee LS; Department of Urology, Sengkang General Hospital, Singapore 544886, Singapore., Teoh JY; S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria., Chan E; S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Aug 12; Vol. 16 (16). Date of Electronic Publication: 2024 Aug 12.
DOI: 10.3390/cancers16162826
Abstrakt: Introduction: Robot-assisted radical cystectomy (RARC) has gained momentum in the management of muscle invasive bladder cancer (MIBC). Predictors of RARC outcomes are not thoroughly studied. We aim to investigate the implications of preoperative hydronephrosis on oncological outcomes.
Patients and Methods: This study analysed data from the Asian RARC consortium, a multicentre registry involving nine Asian centres. Cases were divided into two groups according to the presence or absence of pre-operative hydronephrosis. Background characteristics, operative details, perioperative outcomes, and oncological results were reviewed. Outcomes were (1) survival outcomes, including 10-year disease-free survival (DFS) and overall survival (OS), and (2) perioperative and pathological results. Multivariate regression analyses were performed on survival outcomes.
Results: From 2007 to 2020, 536 non-metastatic MIBC patients receiving RARC were analysed. 429 had no hydronephrosis (80.0%), and 107 (20.0%) had hydronephrosis. Hydronephrosis was found to be predictive of inferior DFS (HR = 1.701, p = 0.003, 95% CI = 1.196-2.418) and OS (HR = 1.834, p = 0.008, 95% CI = 1.173-2.866). Subgroup analysis demonstrated differences in the T2-or-above subgroup (HR = 1.65; p = 0.004 in DFS and HR = 1.888; p = 0.008 in OS) and the T3-or-above subgroup (HR = 1.757; p = 0.017 in DFS and HR = 1.807; p = 0.034 in OS).
Conclusions: The presence of preoperative hydronephrosis among MIBC patients carries additional prognostic implications on top of tumour staging. Its importance in case selection needs to be highlighted.
Databáze: MEDLINE
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