Presurgical anemia as a predictor of relapse and survival in bladder carcinoma treated with cystectomy.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 382-382 ◽  
Author(s):  
Alvaro Pinto ◽  
Luis Eduardo García ◽  
Esther García ◽  
Noelia Herradon ◽  
Enrique Espinosa
Keyword(s):  
Lymph Node ◽  
Radical Cystectomy ◽  
Bladder Carcinoma ◽  
Performance Status ◽  
Univariate Analysis ◽  
Developed Countries ◽  
Lymph Node Status ◽  
Ecog Performance Status ◽  
Node Status ◽  
Muscle Invasive

382 Background: Bladder carcinoma is the fifth most common neoplasm in developed countries. When muscle-invasive disease is diagnosed in a localized stage, radical cystectomy is the standard treatment, with or without perioperative chemotherapy. In this retrospective study we aim to identify presurgical factors that correlate with relapse risk and survival in patients being treated with radical cystectomy without neoadjuvant chemotherapy. Methods: Patients with a history of radical cystectomy for non-metastatic muscle-invasive bladder carcinoma from 1995 to 2010 were included. They had to have an appropriate follow-up, and tissue available for further correlative studies. Demographic baseline features and therapy outcomes were collected in a retrospective fashion. Results: A total of 158 patients were included, with a median overall survival (OS) for the entire cohort of 51 months (95% IC: 17.1–84.9 months). Median relapse free survival (RFS) is 39 months (95% IC: 3.8–74.1 months). In univariate analysis, the following features were prognostic factors for RFS: ECOG performance status (0 vs ³1; 72 vs 20 months, p=0.014), hemoglobin levels (normal vs low; 144 vs 21 months, p=0.001), free surgical margins (yes vs no; 39 vs 11 months, p=0.004), lymph node status (pN0 vs pN+; 119 vs 18 months, p<0.001) and pT stage (pT2 vs pT3-4; 167 vs 20 months, p< 0.001). Other previously described factors, such as neutrophil-lymphocite ratio, thrombocytosis, creatinine clearance or the presence of hydronephrosis, were not significant in our group of patients. In the multivariate analysis, only ECOG (HR 2.32), lymph node status (HR 2.0) and hemoglobin levels (HR 1.71) were independent predictors for RFS. Conclusions: In our group of patients, apart from ECOG performance status and lymph node status, the presence of presurgical anemia could be an indicator of poorer outcomes after cystectomy. These patients should be monitored closely and maybe considered for further therapeutic procedures, such as adjuvant systemic therapy.

Effect of delayed radical cystectomy for invasive bladder tumors on lymph node positivity, cancer-specific survival and total survival

2018 ◽  
Vol 104 (6) ◽  
pp. 434-437
Author(s):  
Hakan Türk ◽  
Sıtkı Ün ◽  
Ahmet Cinkaya ◽  
Hilmi Kodaz ◽  
Murtaza Parvizi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Lymph Node ◽  
Radical Cystectomy ◽  
Transitional Cell ◽  
Invasive Bladder Cancer ◽  
Lymph Node Status ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Specific Survival ◽  
Muscle Invasive

Introduction: Radical cystectomy (RC) is the main treatment option for patients with muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC), which carry the highest risk of progression. In this study, we investigated the effect of time from transurethral resection of the bladder (TUR-B) to cystectomy on lymph node positivity, cancer-specific survival and overall survival in patients with MIBC. Methods: The records were reviewed of 530 consecutive patients who had RC and pelvic lymphadenectomy procedures with curative intent performed by selected surgeons between May 2005 and April 2016. Our analysis included only patients with transitional cell carcinoma of the bladder; we excluded 23 patients with other types of tumor histology. Results: Patients who underwent delayed RC were compared with patients who were treated with early RC; both groups were similar in terms of age, gender, T stage, tumor grade, tumor differentiation, lymph node status and metastasis status. However, when both groups were compared for disease-free survival and overall survival, patients of the early-RC group had a greater advantage. Conclusions: The optimal time between the last TUR-B and RC is still controversial. A reasonable time for preoperative preparation can be allowed, but long delays, especially those exceeding 3 months, can lead to unfavorable outcomes in cancer control.

scholarly journals Prognostic factors for pulmonary large-cell neuroendocrine carcinoma: a competing-risks analysis

2019 ◽  
Author(s):  
Qian Huang ◽  
Jie Liu ◽  
Qiao Huang ◽  
Huifang Cai ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Function Analysis ◽  
Univariate Analysis ◽  
Large Cell ◽  
Tnm Stage ◽  
Lymph Node Status ◽  
Ajcc Stage ◽  
Node Status ◽  
N3 Lymph Node

Abstract Background Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare and highly invasive subtype of lung cancer that accounts for fewer than 3% of cases. The prognostic factors for pulmonary LCNEC are unclear in the literature. Methods Patients diagnosed with pulmonary LCNEC between 2004 and 2015 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. The CumIncidence function was used for the univariate analysis. Multivariate analysis was performed using Cox regression analysis, subdistribution hazard function analysis, and cause-specific hazard function analysis. Results We finally screened 1246 patients diagnosed with pulmonary LCNEC, among whom 796 died of LCNEC and 141 died from other causes. The univariate analysis showed that sex, primary site, laterality, American Joint Committee on Cancer (AJCC) stage, T stage, N stage, M stage, lymph-node status, surgery, and chemotherapy were significant prognostic factors for pulmonary LCNEC (P<0.05). The multivariate analysis demonstrated that sex, AJCC stage, TNM stage T4, TNM stage N3, lymph-node status, surgery, and chemotherapy were independent risk factors for the prognosis (P<0.05). Conclusion We have conducted a competing-risks analysis of patients with pulmonary LCNEC in the SEER database. The results showed that sex, AJCC stage, TNM stage T4, TNM stage N3, lymph-node status, surgery, and chemotherapy are independent prognostic factors for pulmonary LCNEC patients. The reported data represent reference information that can be used for accurate assessments of the prognosis of pulmonary LCNEC patients.

scholarly journals RLC score (R status, lymphovascular invasion, C-reactive protein) predicts survival following radical cystectomy for muscle-invasive bladder cancer

2021 ◽  
Author(s):  
Julian Peter Struck ◽  
Marie Christine Hupe ◽  
Annika Heinisch ◽  
Tomasz Ozimek ◽  
Martin Johannes Peter Hennig ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Radical Cystectomy ◽  
Lymphovascular Invasion ◽  
Prognostic Score ◽  
Invasive Bladder Cancer ◽  
Lymph Node Status ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Abstract Background CRP-based scoring systems were found to correlate with survival in patients with urooncologic diseases. Our retrospective single-centre study aimed to confirm CRP as a prognostic parameter in patients with bladder cancer (BCa) undergoing radical cystectomy (RC) and, based on the findings, to develop our own outcome score for muscle-invasive bladder cancer (MIBC) patients undergoing RC in order to identify patients with a high risk of mortality. Material and methods A total of 254 patients who underwent RC at Hanover Medical School between 1996 and 2007 were reviewed with a follow-up until autumn 2013. The clinicopathologic parameters assessed included age, co-morbidities, pre-/postoperative serum levels of CRP, leukocytes, haemoglobin, creatinine, urinary diversion, tumour grading, staging, lymph node status, lymph node density (LND), lymphovascular invasion (LVI), metastases, and resection margin status. The Chi-square test was used for univariate analyses. Kaplan-Meier estimates and the log-rank test were used for survival analyses. Regarding outcome, overall survival (OS) was assessed. Results The multivariate analysis excluding lymph node (LN)-positive and metastatic patients at time of RC showed a significant association of R status (R; p < 0.001), LVI (L; p = 0.021) and preoperative CRP level > 5 mg/l (C; p = 0.008) with OS. Based on these parameters, the RLC score was developed. The median OS in the intermediate, high-risk and very high-risk groups according to the RLC score was 62, 22, and 6.5 months, respectively. The score had a high predictive accuracy of 0.752. Conclusion The RLC score identifies BCa patients at a higher risk of overall mortality after RC. Overall, our study supports the role of CRP in prognostic score models for BCa.

P27 as a Prognostic Factor of Early Cervical Carcinoma

2013 ◽  
Vol 23 (1) ◽  
pp. 164-169 ◽  
Author(s):  
Jiri Bouda ◽  
Ondrej Hes ◽  
Miroslava Koprivova ◽  
Martin Pesek ◽  
Tomas Svoboda ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Cervical Carcinoma ◽  
Univariate Analysis ◽  
Figo Stage ◽  
Lymph Node Status ◽  
Tumor Diameter ◽  
Stage Ib ◽  
Node Status

ObjectiveThe aim of this study was to clarify whether the evaluation of cell-cycle regulatory protein p27 can serve as a prognostic factor in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical carcinoma.Patients and MethodsA retrospective study was performed on 130 surgically treated patients with FIGO stage IB cervical carcinoma with at least a 5-year follow-up. The expression of p27 was investigated independently by 2 experienced pathologists using immunohistochemistry. The prognostic significance of established prognostic factors and p27 expression were analyzed using univariate and multivariate analyses.ResultsIn a univariate analysis, lymph node status, tumor diameter, Gynecologic Oncology Group (GOG) score, lymph vascular space invasion, and p27 expression were significant prognostic factors for overall survival (OS). We found a correlation between p27 expression and lymph node status, tumor diameter, invasion, and GOG score. The p27 expression was a statistically significant prognostic factor for OS in a univariate analysis (log-rank test, P = 0.03). In a multivariate analysis, only lymph node status and tumor diameter were statistically significant prognostic factors for OS.ConclusionsThis study demonstrated that a low p27 expression is associated with lymph node metastasis, deep stromal invasion, tumor diameter more than 20 mm, and high GOG score and had a prognostic influence on OS in a univariate analysis in a series of 130 women with FIGO stage IB cervical carcinoma. Lymph node status and the diameter of the tumor were the only statistically significant prognostic factors in multivariate analysis.

scholarly journals Regional lymph node status in patients with bladder cancer found to be pathological stage T0 at radical cystectomy following systemic chemotherapy

2011 ◽  
Vol 108 (8b) ◽  
pp. E272-E277 ◽  
Author(s):  
Matthew G. Kaag ◽  
Matthew I. Milowsky ◽  
Guido Dalbagni ◽  
R. Houston Thompson ◽  
Darren Katz ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Radical Cystectomy ◽  
Systemic Chemotherapy ◽  
Regional Lymph Node ◽  
Lymph Node Status ◽  
Pathological Stage ◽  
Node Status

scholarly journals Utility of pT3 substaging in lymph node-negative urothelial carcinoma of the bladder: do pathologic parameters add to prognostic sub-stratification?

2021 ◽  
Author(s):  
Moritz Maas ◽  
Johannes Mischinger ◽  
Eva Compérat ◽  
Marcus Scharpf ◽  
Falko Fend ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Cystectomy ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Free Survival ◽  
Node Negative ◽  
Prospective Cohorts ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

Abstract Purpose The value of bladder cancer (BC) substaging into macroscopic (pT3b) and microscopic (pT3a) perivesical fat extension in lymph node (Ln)-negative patients is controversially discussed and limited evidence for prognostic relevance of additional histopathological factors in pT3 BC exists. We evaluated the prognostic value of pT3 substaging and established pathological and clinical parameters with focus on tumor invasive front (TIF) and tumor size. Methods Specimens of 52 patients treated with radical cystectomy (RC) for pT3 a/b muscle-invasive BC were reviewed and re-evaluated by a pathologist specialized in uropathology. Clinical variables and standard histopathologic characteristics were assessed including TIF and tumor size. Their value as prognosticators for overall survival (OS) and recurrence-free survival (RFS) was evaluated. Results Mean age of patients was 67.55 years. Tumors were staged pT3a in 28 patients (53.8%) and pT3b in 24 (46.8%). Median OS was 34.51 months. Median tumor size was 3.2 cm, median TIF was 11.0 mm. Differences in OS between pT3a and pT3b were not significant (p = 0.45). Carcinoma in situ (CIS) and lymphovascular invasion (LVI) were significantly associated with pT3b tumors. Univariate analysis could not identify pathological prognosticators like TIF or tumor size for OS and RFS (p for all > 0.05). Conclusion No significant differences in OS or RFS were observed comparing Ln-negative pT3 BC following radical cystectomy. Additional pathologic variables like TIF could not be identified as prognosticator. Relevance of pT3 BC substaging needs reevaluation in larger prospective cohorts.

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