1988 PREOPERATIVE SERUM INTERLEUKIN-6 SOLUBLE RECEPTOR PREDICTS LYMPH NODE METASTASIS AND CANCER SPECIFIC SURVIVAL IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE BLADDER UNDERGOING RADICAL CYSTECTOMY AND EXTENDED LYMPH NODE DISSECTION

Abstract

You have accessJournal of UrologyBladder Cancer: Metastatic Disease1 Apr 20111988 PREOPERATIVE SERUM INTERLEUKIN-6 SOLUBLE RECEPTOR PREDICTS LYMPH NODE METASTASIS AND CANCER SPECIFIC SURVIVAL IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE BLADDER UNDERGOING RADICAL CYSTECTOMY AND EXTENDED LYMPH NODE DISSECTION Peter Jian, Guilherme Godoy, Gilad E. Amiel, and Seth P. Lerner Peter JianPeter Jian Houston, TX More articles by this author , Guilherme GodoyGuilherme Godoy Houston, TX More articles by this author , Gilad E. AmielGilad E. Amiel Houston, TX More articles by this author , and Seth P. LernerSeth P. Lerner Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2214AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preoperative prediction of adverse pathologic and oncologic outcomes is relevant for decision making in patients with bladder cancer. We have previously shown that preoperative serum levels of interleukin-6 soluble receptor (IL6sR) is an independent prognostic factor for lymphovascular invasion (LVI), lymph node (LN) metastases, and disease specific mortality (J Urol, 167: 1475–81, 2002). The present study is an extension of the previous study with a larger patient population and longer follow-up. METHODS We identified 453 consecutive patients who underwent radical cystectomy (RC) and extended LN dissection (eLND) by two surgeons between April 1992 and October 2010 for bladder cancer. The entry criteria for the study were urothelial carcinoma histology and presence of the IL6sR serum marker collected before surgery, identifying 95 patients for the analysis. Data elements included age at RC, gender, clinical and pathologic stage and grade, tumor histology, presence of carcinoma in situ and LVI in the specimen, surgical margins, and cancer-specific and overall survival. RESULTS The median age at cystectomy was 66 years (interquartile range [IQR] 59, 73). 91% of the patients were males, and median follow-up for patients alive was 59 months (IQR 34, 71). 70.3% and 66.3% of the patients had clinically and pathologically muscle-invasive disease on final specimen, respectively. LN metastasis was present in 33.3% of the patients, and LVI in 50.5% of the patients. At the time of the analysis, 21 patients have died of disease. Regression models using the median value of IL6sR (26.7 pg/mL) as a cutoff showed that it was independently associated with LN metastasis, when controlled for age and gender (odds ratio [OR] 2.94, 95% confidence interval [CI] (1.18, 7.34), p=0.021) or grade (OR 2.84, 95%CI (1.14, 7.09), p=0.025). IL6sR was an independent predictor of cancer-specific survival (hazard ratio 2.86, 95%CI (1.13, 7.26), p=0.027), when controlled for age, invasive pT-stage and presence of CIS in the specimen. Using Kaplan-Meier method, the estimated 5-year survival rates for patients with IL6sR below and above 26.7pg./mL were 79.1% and 70%, respectively (log-rank p=0.038). CONCLUSIONS Preoperative serum IL6sR predicts LN metastasis and cancer-specific survival in patients with urothelial carcinoma of the bladder undergoing RC and eLND. Prospective studies are needed to further assess the role of IL6sR on perioperative disease management. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e795-e796 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Jian Houston, TX More articles by this author Guilherme Godoy Houston, TX More articles by this author Gilad E. Amiel Houston, TX More articles by this author Seth P. Lerner Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...