PD18-10 THE TNR-C SCORE QUALIFIES AS A PROGNOSTIC TOOL FOR PATIENTS UNDERGOING RADICAL CYSTECTOMY: RESULTS OF AN EXTERNAL VALIDATION

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 2014PD18-10 THE TNR-C SCORE QUALIFIES AS A PROGNOSTIC TOOL FOR PATIENTS UNDERGOING RADICAL CYSTECTOMY: RESULTS OF AN EXTERNAL VALIDATION Mario Kramer, Annika Heinisch, Mahmoud Abbas, Gerd Wegener, Inga Peters, Christoph Von Klot, Hossein Tezval, Thomas R.W. Herrmann, Markus A. Kuczyk, and Axel S. Merseburger Mario KramerMario Kramer More articles by this author , Annika HeinischAnnika Heinisch More articles by this author , Mahmoud AbbasMahmoud Abbas More articles by this author , Gerd WegenerGerd Wegener More articles by this author , Inga PetersInga Peters More articles by this author , Christoph Von KlotChristoph Von Klot More articles by this author , Hossein TezvalHossein Tezval More articles by this author , Thomas R.W. HerrmannThomas R.W. Herrmann More articles by this author , Markus A. KuczykMarkus A. Kuczyk More articles by this author , and Axel S. MerseburgerAxel S. Merseburger More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1505AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Systemic inflammation has been described as a common reaction to cancer progression. Besides other malignancies, elevated serum CRP levels have been sparsely reported in bladder cancer patients prior to treatment. The aim of this study was to analyze whether our patient cohort showed association of CRP levels and survival after radical cystectomy as well as for external validation of the recently described TNR-C score. Methods We retrospectively reviewed charts of patients undergoing radical cystectomy and bilateral pelvic lymphadenectomy between 1996 and 2005 identifying 279 patients of which 194 had preoperative CRP levels and no concomitant infection. CRP levels were defined as elevated if they were >5 mg/l. Cancer-specific outcome was predicted based on the aforementioned CRP-based scoring model (T=T-stage; N=N-stage; R=residual tumor; C=CRP). The mean follow-up was 29 months (0-131). Results Elevated serum CRP levels were found in 89 (45.9%) patients preoperatively. These patients were more likely to have advanced tumor stages (pT3-4; p<0.01), positive resection margins (p<0.01) and positive lymph nodes (p<0.05). Cancer specific survival was decreased by approx. 17% after 12, 36 and 60 months. In multivariate analysis, CRP was identified as an independent prognostic indicator for poor cancer-specific survival. The 3-year CSS in patients with a TNR-score in the ranges 0-2, 3-6 and 7-10 was 74.0%, 33.3% and 4.0%, respectively (p<0.001) with a concordance index of 0,833 (p<0.001). Conclusions The prognostic impact of the TNR-C score has been validated. Elevated preoperative CRP levels might be used in nomograms to predict poor survival after radical cystectomy. However, more evidence, especially from prospective studies is needed. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e538-e539 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Mario Kramer More articles by this author Annika Heinisch More articles by this author Mahmoud Abbas More articles by this author Gerd Wegener More articles by this author Inga Peters More articles by this author Christoph Von Klot More articles by this author Hossein Tezval More articles by this author Thomas R.W. Herrmann More articles by this author Markus A. Kuczyk More articles by this author Axel S. Merseburger More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...