Article
The prognostic value of postoperative clinical and laboratory parameters concerning the oncological outcome of patients undergoing radical cystectomy for urothelial cell carcinoma of the bladder: A single centre study
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Published: | April 20, 2016 |
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Introduction & objectives: Radical cystectomy (RC) with bilateral lymph node dissection represents the current gold standard for the curative treatment of both: localized muscle-invasive bladder cancer (MIBC) and high-risk BCG-refractory non-muscle invasive bladder cancer (NMIBC). RC can be associated with a substantial postoperative morbidity potentially compromising the oncological outcome. So far there is only limited data suggesting postoperative clinical and laboratory parameters that could predict the oncological outcome. The aim of this study was to evaluate potential postoperative parameters to predict the oncological outcome of patients undergoing RC for UCC.
Material and methods: A retrospective data analysis of patients undergoing RC between 2004 and 2015 for UCC of the bladder was performed at a single institution. Besides routine blood parameters (leucocytes, creatinine, haemoglobin (Hb), CRP and thrombocytes), Clavien-classification, wound healing disorders and length of stay at the intensive care unit (ICU) were recorded. For all parameters a hazard ratio (HR) concerning the cancer specific survival (CSS) was calculated on a univariate basis. Secondly a HR was calculated respecting the given postoperative parameters while including also postoperative staging (TNM-classification) parameters on a multivariate basis.
Results: In total 751 patients (n=751) were identified. The HR concerning CSS was significant in univariate analysis for following parameters: creatinine-level, CRP-level, thrombocyte count, post-operative wound healing disorders, Clavien-Score and postoperative length of stay at the ICU. With the inclusion of the post-interventional TNM-classification the HR concerning CSS turned out to be significant on a multivariate analysis for TNM-values only.
Conclusion: In univariate analysis routine postoperative blood parameters, such as creatinine, CRP and thrombocyte count seem to be associated with a decrease in CSS of patients undergoing RC for UCC of the bladder. ICU inhabitancy and wound healing disorders after RCX also show a degrading tendency regarding CSS in our cohort. However, multivariate analysis respecting postoperative TNM information shows that the studied parameters are no independent predictive markers for CSS in patients undergoing radical cystectomy.