Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy
Abstract Background Early identification of early death for bladder cancer patients undergoing radical cystectomy based on the laboratory findings at the time of diagnosis could improve the overall survival. The study aimed to explore preoperative factors associated with higher risk of early death (...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-07-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.2237 |
| _version_ | 1811238343231406080 |
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| author | Zhaowei Zhu Xiaojing Wang Jiange Wang Shengzheng Wang Yafeng Fan Tianlong Fu Songqiang Cao Xuepei Zhang |
| author_facet | Zhaowei Zhu Xiaojing Wang Jiange Wang Shengzheng Wang Yafeng Fan Tianlong Fu Songqiang Cao Xuepei Zhang |
| author_sort | Zhaowei Zhu |
| collection | DOAJ |
| description | Abstract Background Early identification of early death for bladder cancer patients undergoing radical cystectomy based on the laboratory findings at the time of diagnosis could improve the overall survival. The study aimed to explore preoperative factors associated with higher risk of early death (within 1 year after surgery) for bladder cancer patients. Methods A total of 186 bladder cancer patients who underwent robot‐assisted radical cystectomy (RARC) were identified between October 2014 and May 2017. The probability of dying within 1 year after RARC was defined as the end point “early death.” Predictive factors including clinical features and laboratory findings at diagnosis were retrospectively collected. Results Median follow‐up time after RARC was 20.6 months (1.2‐43.7 months). Fifty‐one patients (27.4%) died during follow‐up and 31 within 1 year from surgery (1‐year mortality rate: 16.7%). All potentially prognostic factors were assessed on univariate analyses, which revealed the following factors as being associated with higher risk of early death within 1 year after RARC: older age (P = 0.004), advanced clinical stage (P = 0.005), presence of hydronephrosis (P = 0.021), higher fibrinogen (P = 0.007), higher PLR (P = 0.031), and lower PNI (P = 0.016). In a multivariate Cox proportional hazard regression model analysis, age >60 years (HR = 7.303, 95% CI 1.734‐30.764; P = 0.007) and fibrinogen ≥3.295 g/L (HR = 2.396, 95% CI 1.138‐5.045; P = 0.007) at diagnosis were independent prognostic factors of early death after RARC. Conclusion Age and preoperative elevated plasma fibrinogen level were independent predictors for 1‐year mortality after RARC. We believe that plasma fibrinogen levels may become a useful biomarker, which may help guide the treatment decision‐making process for patients with bladder cancer. |
| first_indexed | 2024-04-12T12:41:11Z |
| format | Article |
| id | doaj.art-f72162ac6fa34151a0ee2d174132a644 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-12T12:41:11Z |
| publishDate | 2019-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-f72162ac6fa34151a0ee2d174132a6442022-12-22T03:32:47ZengWileyCancer Medicine2045-76342019-07-01873447345210.1002/cam4.2237Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomyZhaowei Zhu0Xiaojing Wang1Jiange Wang2Shengzheng Wang3Yafeng Fan4Tianlong Fu5Songqiang Cao6Xuepei Zhang7Department of Urology The First Affiliated Hospital of Zhengzhou University Zhengzhou PR ChinaDepartment of Urology Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai ChinaDepartment of Urology The First Affiliated Hospital of Zhengzhou University Zhengzhou PR ChinaDepartment of Urology The First Affiliated Hospital of Zhengzhou University Zhengzhou PR ChinaDepartment of Urology The First Affiliated Hospital of Zhengzhou University Zhengzhou PR ChinaDepartment of Urology Zhengzhou Central Hospital Zhengzhou PR ChinaDepartment of Urology Huaihe Hospital of Henan University Kaifeng PR ChinaDepartment of Urology The First Affiliated Hospital of Zhengzhou University Zhengzhou PR ChinaAbstract Background Early identification of early death for bladder cancer patients undergoing radical cystectomy based on the laboratory findings at the time of diagnosis could improve the overall survival. The study aimed to explore preoperative factors associated with higher risk of early death (within 1 year after surgery) for bladder cancer patients. Methods A total of 186 bladder cancer patients who underwent robot‐assisted radical cystectomy (RARC) were identified between October 2014 and May 2017. The probability of dying within 1 year after RARC was defined as the end point “early death.” Predictive factors including clinical features and laboratory findings at diagnosis were retrospectively collected. Results Median follow‐up time after RARC was 20.6 months (1.2‐43.7 months). Fifty‐one patients (27.4%) died during follow‐up and 31 within 1 year from surgery (1‐year mortality rate: 16.7%). All potentially prognostic factors were assessed on univariate analyses, which revealed the following factors as being associated with higher risk of early death within 1 year after RARC: older age (P = 0.004), advanced clinical stage (P = 0.005), presence of hydronephrosis (P = 0.021), higher fibrinogen (P = 0.007), higher PLR (P = 0.031), and lower PNI (P = 0.016). In a multivariate Cox proportional hazard regression model analysis, age >60 years (HR = 7.303, 95% CI 1.734‐30.764; P = 0.007) and fibrinogen ≥3.295 g/L (HR = 2.396, 95% CI 1.138‐5.045; P = 0.007) at diagnosis were independent prognostic factors of early death after RARC. Conclusion Age and preoperative elevated plasma fibrinogen level were independent predictors for 1‐year mortality after RARC. We believe that plasma fibrinogen levels may become a useful biomarker, which may help guide the treatment decision‐making process for patients with bladder cancer.https://doi.org/10.1002/cam4.2237risk assessmentsurgical oncologysurvivalurological oncology |
| spellingShingle | Zhaowei Zhu Xiaojing Wang Jiange Wang Shengzheng Wang Yafeng Fan Tianlong Fu Songqiang Cao Xuepei Zhang Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy Cancer Medicine risk assessment surgical oncology survival urological oncology |
| title | Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy |
| title_full | Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy |
| title_fullStr | Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy |
| title_full_unstemmed | Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy |
| title_short | Preoperative predictors of early death risk in bladder cancer patients treated with robot‐assisted radical cystectomy |
| title_sort | preoperative predictors of early death risk in bladder cancer patients treated with robot assisted radical cystectomy |
| topic | risk assessment surgical oncology survival urological oncology |
| url | https://doi.org/10.1002/cam4.2237 |
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