MP49-07 THE RISK OF POSTOPERATIVE VENOUS THROMBOEMBOLISM ACCORDING TO THE CIRCULATING TUMOR CELL STATUS IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE BLADDER TREATED WITH RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2016MP49-07 THE RISK OF POSTOPERATIVE VENOUS THROMBOEMBOLISM ACCORDING TO THE CIRCULATING TUMOR CELL STATUS IN PATIENTS WITH UROTHELIAL CARCINOMA OF THE BLADDER TREATED WITH RADICAL CYSTECTOMY Armin Soave, Sabine Riethdorf, Roland Dahlem, Lars Weisbach, Valentin Maurer, Oliver Engel, Sarah Minner, Klaus Pantel, Margit Fisch, and Michael Rink Armin SoaveArmin Soave More articles by this author , Sabine RiethdorfSabine Riethdorf More articles by this author , Roland DahlemRoland Dahlem More articles by this author , Lars WeisbachLars Weisbach More articles by this author , Valentin MaurerValentin Maurer More articles by this author , Oliver EngelOliver Engel More articles by this author , Sarah MinnerSarah Minner More articles by this author , Klaus PantelKlaus Pantel More articles by this author , Margit FischMargit Fisch More articles by this author , and Michael RinkMichael Rink More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.420AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urothelial carcinoma of the bladder (UCB) patients are at a relevant risk for venous thromboembolism (VTE) following radical cystectomy (RC). In other cancer entities, circulating tumor cells (CTC) are associated with an increased risk of VTE. To evaluate whether the presence of CTC is associated with an increased postoperative risk of VTE and surgical complications in UCB patients treated with RC. METHODS We included 201 UCB patients treated with RC with bilateral pelvic lymphadenectomy without neoadjuvant chemotherapy at an academic center between 2007 and 2014. Preoperatively collected blood samples (7.5 ml) were analyzed for CTC using the CellSearch® system (Janssen, USA). Postoperative VTE was defined as clinically apparent venous thrombosis and/or pulmonary embolism following RC, and was confirmed by diagnostic imaging studies. Data on postoperative VTE and complications were collected retrospectively by patients' chart review. Postoperative complications were classified according to the Clavien-Dindo classification of surgical complications. Clinico-pathologic features were correlated with the VTE status and the CTC status. RESULTS Prior to RC, 54 patients (26.9%) had presence of CTC (mean CTC number: 4.9±31.3 (standard deviation (SD); median: 0; range: 0-372). Within 30 days postoperatively, 6 patients (3.0%) had VTE, and 136 patients (67.7%) had any surgical complication. The most frequent complications were Clavien-Dindo grade 1 and 2 complications in 95 patients (47.3%), followed by grade 3 complications in 25 patients (12.4%) and grade 4 complications in 15 patients (7.5%), respectively. The presence of VTE was not associated with the CTC status or any other clinico-pathologic characteristics. There was no difference in the number of CTC in patients with VTE (mean CTC number: 1.0±1.5 SD) and without VTE (mean CTC number: 5.0±31.7 SD), respectively. The VTE status and the CTC status were not associated with surgical complications. The presence of CTC was associated with a positive soft tissue surgical margin, the presence of lymphovascular and micro-vessel invasion, and the administration of adjuvant chemotherapy (all p-values≤0.045). CONCLUSIONS While complications occur frequently within 30 days after RC, VTE are relatively rare events. Following RC, UCB patients with presence of CTC do not seem to be at an increased risk of VTE. In addition, the presence of CTC is not associated with surgical complications. However, a longer follow-up is urgently warranted. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e666-e667 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Armin Soave More articles by this author Sabine Riethdorf More articles by this author Roland Dahlem More articles by this author Lars Weisbach More articles by this author Valentin Maurer More articles by this author Oliver Engel More articles by this author Sarah Minner More articles by this author Klaus Pantel More articles by this author Margit Fisch More articles by this author Michael Rink More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...