PD36-05 THE PROGNOSTIC VALUE OF POSTOPERATIVE CLINICAL AND LABORATORY PARAMETERS REGARDING THE ONCOLOGICAL OUTCOME OF PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR UROTHELIAL CELL CARCINOMA OF THE BLADDER

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2017PD36-05 THE PROGNOSTIC VALUE OF POSTOPERATIVE CLINICAL AND LABORATORY PARAMETERS REGARDING THE ONCOLOGICAL OUTCOME OF PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR UROTHELIAL CELL CARCINOMA OF THE BLADDER Jan-Friedrich Jokisch, Tobias Grimm, Alexander Buchner, Alexander Kretschmar, Gerald Schulz, Birte Schneevoigt, Christian Stief, and Alexander Karl Jan-Friedrich JokischJan-Friedrich Jokisch More articles by this author , Tobias GrimmTobias Grimm More articles by this author , Alexander BuchnerAlexander Buchner More articles by this author , Alexander KretschmarAlexander Kretschmar More articles by this author , Gerald SchulzGerald Schulz More articles by this author , Birte SchneevoigtBirte Schneevoigt More articles by this author , Christian StiefChristian Stief More articles by this author , and Alexander KarlAlexander Karl More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1554AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical cystectomy (RC) represents the current standard for the curative treatment of localized muscle-invasive and high-risk BCG-refractory non-muscle invasive bladder cancer (BC). Besides its curative intention RC can be associated with a substantial postoperative morbidity compromising the oncological outcome. So far there is only limited data suggesting postoperative clinical and laboratory parameters that could predict the oncological outcome and the cancer specific survival (CSS), respectively. The aim of this study was to evaluate potential postoperative clinical and laboratory parameters to predict the oncological outcome of patients undergoing RC for BC. METHODS A single-centred retrospective data analysis of patients undergoing RC between 2004 and 2015 for BC was performed. Besides routine blood parameters (leucocytes, creatinine, Hb, CRP and thrombocytes), Clavien-classification, wound healing disorders (WD) and length of stay at the intensive care unit (ICU) were recorded. For all parameters a hazard ratio (HR) concerning the CSS was calculated on a univariate basis. Secondly a HR was calculated respecting the given postoperative parameters while including also postoperative staging (TNM-classification) parameters on a multivariate basis. RESULTS In total 751 patients (n=751) with a complete dataset were identified. The HR concerning CSS was significant in univariate analysis for following parameters: creatinine-level (HR=1.34; p <0.001), CRP-level (HR=1.03; p0.031), thrombocyte count (HR=1.0002; p=0.037), post-operative WD (HR=1.85; p<0.001), Clavien-Score (1-3 vs. 3+) (HR=1.47;p= =0.027) and postoperative length of stay at the ICU (HR=2.84;p0.001). With the inclusion of the post-interventional TNM-classification the HR concerning CSS turned out to be significant on a multivariate analysis for TNM-values only. (pT<3 vs. pT3-4 HR=3.48, p =0.001; pN0 vs. pN+ HR=1.60, p =0.037 and M0 vs. M1 HR=2.44, p= 0.005). CONCLUSIONS In univariate analysis routine postoperative blood parameters, such as creatinine, CRP and thrombocyte count seem to be associated with a decrease in CSS. A closer monitoring and potentially intervention in a postoperative setting might be beneficial for these patients. ICU inhabitancy and WD after RC also show a degrading tendency regarding CSS in our cohort. However, multivariate analysis respecting TNM information shows that the studied parameters are no independent predictive markers for CSS. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e670 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jan-Friedrich Jokisch More articles by this author Tobias Grimm More articles by this author Alexander Buchner More articles by this author Alexander Kretschmar More articles by this author Gerald Schulz More articles by this author Birte Schneevoigt More articles by this author Christian Stief More articles by this author Alexander Karl More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...