MP58-10 PREOPERATIVE HEMOGLOBIN TO PLATELET RATIO AS A PREDICTOR OF SURVIVAL AFTER RADICAL CYSTECTOMY.

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive V1 Apr 2017MP58-10 PREOPERATIVE HEMOGLOBIN TO PLATELET RATIO AS A PREDICTOR OF SURVIVAL AFTER RADICAL CYSTECTOMY. Giovanni La Croce, Marco Moschini, Alessandro Nini, Dell'Oglio Paolo, Eugenio Ventimiglia, Ettore Di Trapani, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Andrea Gallina, and Renzo Colombo Giovanni La CroceGiovanni La Croce More articles by this author , Marco MoschiniMarco Moschini More articles by this author , Alessandro NiniAlessandro Nini More articles by this author , Dell'Oglio PaoloDell'Oglio Paolo More articles by this author , Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Ettore Di TrapaniEttore Di Trapani More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , and Renzo ColomboRenzo Colombo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1805AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The role of cancer-related inflammation pathways as proxy of aggressiveness is well known in several cancers. Preoperative anemia and thrombocytosis are known to be associated with aggressive disease features in bladder cancer (BCa). Accordingly, we hypothesized that a single variable including hemoglobin (HB) and platelet count (PLT) (HB to PLT ratio [HPR]) could consider the synergic effect of both factors. We aim to evaluate if HPR can represent a predictor of cancer specific mortality (CSM) or overall mortality (OM) in patients treated with radical cystectomy (RC) for BCa METHODS We evaluated 963 patients diagnosed with BCa and treated with RC between 1987 and 2015 at our institution. Routine laboratory measurements were performed preoperatively the day before surgery. Univariate and multivariable Cox proportional hazards regression analyses were used to predict CSM and OM. Covariates included age at surgery, gender, pathological T stage, pathological N stage, preoperative hydronephrosis, ASA score, surgical margins, lymph vascular invasion and neoadjuvant chemotherapy RESULTS Median age was 69 years (IQR 62-75 years). HB was measured as g/L while PLT was measured as 10^9 L-1. Preoperative median HPR was 0.55 (IQR 0.41-0.70 ). Overall, 304, 129 and 540 patients were recorded with lymph node metastases, positive surgical margins and pT3-4 stage, respectively. CSM was observed in 385 (39%) patients, whereas OM was observed in 148 patients (48%). Median follow-up was 58 months (IQR 15-84 ). Patients with a HPR lower than 0.55 had adverse pathological characteristics, such as high grade (P < 0.001), advanced T stage (P < 0.001) and lymph node invasion (P < 0.001). At univariate analysis HPR higher than 0.55 was associated with lower risk of CSM and OM (respectively HR 0.224 and 0.291; CI 0.131-0.381 and 0.291-0.468; all p <0.001). At multivariate analysis preoperative HPR was associated with lower risk to incur CSM and OM (respectively HR 0.134 and 0.162; CI 0.05-0.37 and 0.07-0.41; all p <0.001). Other predictors of CSM were N stage and positive margins while neoadjuvant chemotherapy was inversely associated to CSM. Other predictors of OM were ASA score, age at surgery and N stage while neoadjuvant chemotherapy was inversely linked to OM CONCLUSIONS Despite the well known role of anemia and thrombocytosis as predictors of survival in BCa, HPR (that include both factors) should be considered as a powerful prognostic marker, expression of inflammation and of the disease aggressiveness. However further investigations are needed to fully understand the impact of inflammation in BCa © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e776 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Giovanni La Croce More articles by this author Marco Moschini More articles by this author Alessandro Nini More articles by this author Dell'Oglio Paolo More articles by this author Eugenio Ventimiglia More articles by this author Ettore Di Trapani More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Andrea Gallina More articles by this author Renzo Colombo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...