MP56-17 THE IMPACT OF BASELINE CHRONIC KIDNEY DISEASE ON LONG-TERM SURVIVALS OF PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP56-17 THE IMPACT OF BASELINE CHRONIC KIDNEY DISEASE ON LONG-TERM SURVIVALS OF PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS Alireza Ghoreifi, Reza Sari Motlagh, Takafumi Yanagisawa, Tatsushi Kawada, Inderbir Gill, Siamak Daneshmand, Hooman Djaladat, and Shahrokh F Shariat Alireza GhoreifiAlireza Ghoreifi More articles by this author , Reza Sari MotlaghReza Sari Motlagh More articles by this author , Takafumi YanagisawaTakafumi Yanagisawa More articles by this author , Tatsushi KawadaTatsushi Kawada More articles by this author , Inderbir GillInderbir Gill More articles by this author , Siamak DaneshmandSiamak Daneshmand More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , and Shahrokh F ShariatShahrokh F Shariat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003309.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) is a complex surgery with considerable short- and long-term renal and metabolic complications, especially among those with preoperative chronic kidney disease (CKD). The aim of this study is to evaluate the impact of baseline CKD on oncologic and overall survival of patients who underwent RC for bladder cancer. METHODS: PubMed, Web of Science, Cochrane Library, and Scopus databases were searched for articles published by September 2022 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. After quality and risk of bias assessments, eligible studies were included in the meta-analysis. The primary outcome was overall survival (OS) and secondary outcomes included cancer-specific survival (CSS) and metastasis-free survival (MFS) of patients with CKD ≥3 (estimated glomerular filtration rate (GFR) <60 mL/min) undergoing RC. In addition, subgroup meta-analyses were performed in patients with different pre-operative CKD stages. RESULTS: Seven articles with 6900 patients were included in this study. In terms of oncological outcomes, MFS was compromised in patients with higher CKD stage by a HR of 1.54 (95% CI 1.15–2.05). In the subgroup analyses, patients with CKD3b and those with CKD stages ˃2 had a significantly worse MFS (HR=2.94, p ˂ 0.0001 and HR=1.45, p=0.03, respectively) (Figure 1-A). Also, we found that higher CKD stage could reduce CSS (HR 2.09, 95% CI 1.43–3.05). In the subgroup analysis, all subgroup HRs suggest a decreased CSS, however, patients with CKD3b and CKD ˃2 had a significantly worse CSS (HR=3.94, p˂0.0001 and HR=1.88, p=0.007) (Figure 1-B). Additionally, we found that a higher CKD stage could reduce OS by a HR of 1.47 (95% CI 1.21–1.79). Subgroup analyses showed that patients with CKD3a and CKD3b as well as those with CKD4 had a significantly worse OS (HR=1.13, p=0.03; HR=2.13, p=0.08; and HR=1.71, p=0.002, respectively) (Figure 1-C). CONCLUSIONS: Overall and oncological survivals are compromised in patients with CKD undergoing radical cystectomy. This effect is more prominent in patients with higher CKD stages. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e781 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alireza Ghoreifi More articles by this author Reza Sari Motlagh More articles by this author Takafumi Yanagisawa More articles by this author Tatsushi Kawada More articles by this author Inderbir Gill More articles by this author Siamak Daneshmand More articles by this author Hooman Djaladat More articles by this author Shahrokh F Shariat More articles by this author Expand All Advertisement PDF downloadLoading ...