Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schubert, T; Todenhöfer, T; Mischinger, J; Schwentner, C; Renninger, M; Stenzl, A; Gakis, G.
The prognostic role of pre-cystectomy hemoglobin levels in patients with invasive bladder cancer.
World J Urol. 2016; 34(6):829-834
Doi: 10.1007/s00345-015-1693-2
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Mischinger Johannes
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- Abstract:
- To determine whether pre-treatment hemoglobin (Hb) levels in patients with bladder cancer impact on oncological outcomes after radical cystectomy (RC). A consecutive, contemporary series of 246 patients undergoing RC and pelvic lymph node dissection for bladder cancer. Decreased Hb level was defined as ≤12 g/dL. The Kaplan-Meier method was used to estimate recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS). The Fisher exact/Chi-square test was used to investigate differences between both groups. Uni- and multivariable Cox regression analysis addressed risk factors for recurrence, cancer-specific death and overall death. The median follow-up was 30 months (2-116). Of the 246 patients, 182 (74 %) had normal (>12 g/dL) and 64 decreased (≤12 g/dL) preoperative Hb (26 %). In univariable analysis, decreased Hb was associated with increased age, extravesical disease, hydronephrosis (all p < 0.001), node-positive disease and positive resection margins (both p = 0.01). Subanalyzed for patients with organ-confined disease (defined as ≤pT2bN0R0; N = 109), the 3-year RFS, CSS and OS was significantly lower in patients with decreased (34.9, 35.5 and 19.8 %) compared to normal Hb level (69.7, 86.3 and 77.6 %; p = 0.01/p = 0.002/p < 0.001). In multivariable analysis, RFS, CSS and OS were significantly lower in patients with decreased Hb (p = 0.007, p = 0.001 and p = 0.002), pathologically locally advanced tumor (≥pT3a; p = 0.023, p = 0.036 and p = 0.065) and nodal stage (p < 0.001, p = 0.006 and p = 0.001) and positive soft tissue surgical margins (p = 0.040, p = 0.004 and 0.012). Pre-cystectomy Hb levels are associated with adverse histopathologic characteristics and provide additional prognostic information especially for patients with pathologically localized bladder cancer.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Cystectomy -
- Female -
- Hemoglobins - analysis
- Humans -
- Male -
- Middle Aged -
- Neoplasm Invasiveness -
- Prognosis -
- Retrospective Studies -
- Urinary Bladder Neoplasms - blood
- Urinary Bladder Neoplasms - pathology
- Urinary Bladder Neoplasms - surgery
- Find related publications in this database (Keywords)
- Bladder cancer
- Hemoglobin
- Recurrence
- Radical cystectomy
- Survival