Preoperative chronic kidney disease predicts poor oncological outcomes after radical cystectomy in patients with muscle-invasive bladder cancer
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Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Adv Transplant & Regenerat Med
Hirosaki Univ, Grad Sch Med, Dept Urol
Hirosaki Univ, Grad Sch Med, Dept Adv Transplant & Regenerat Med
Hirosaki Univ, Grad Sch Med, Dept Urol
Aomori Rosai Hosp, Dept Urol
Mutsu Gen Hosp, Dept Urol
Aomori Prefectural Cent Hosp
Hirosaki Univ, Grad Sch Med, Dept Urol
抄録
Objective: To evaluate the impact of preoperative chronic kidney disease (CKD) on oncologic outcomes in muscle-invasive bladder cancer patients who underwent radical cystectomy.
Methods: A total of 581 patients who underwent radical cystectomy at four medical centers between January 1995 and February 2017 were examined retrospectively. We investigated oncologic outcomes, including progression-free, cancer-specific, and overall survival (PFS, CSS, and OS, respectively) stratified by preoperative CKD status (pre-CKD vs. non-CKD). We performed a Cox proportional hazards regression analysis using inverse probability of treatment weighting (IPTW) to evaluate the impact of preoperative CKD on prognosis and developed the prognostic factor-based risk stratification nomogram.
Results: Of the 581 patients, 215 (37%) were diagnosed with CKD before radical cystectomy. Before the background adjustment, PFS, CSS, and OS after radical cystectomy were significantly lower in the pre-CKD group compared to the non-CKD group. Background-adjusted IPTW analysis showed that preoperative CKD was significantly associated with poor PFS, CSS, and OS after radical cystectomy. The nomogram for predicting 5-year PFS and OS probability showed significant correlation with actual PFS and OS (c-index = 0.73 and 0.77, respectively).
Conclusions: Muscle-invasive bladder cancer patients with preoperative CKD had a significantly lower survival probability than those without CKD.
運用指針・許諾書
Preoperative chronic kidney disease predicts poor oncological outcomes after radical cystectomy in patients with muscle-invasive bladder cancer
oncotarget-61404
(2.58MB)
