@article{oai:hirosaki.repo.nii.ac.jp:00005476,
 author = {Hamano, Itsuto and Hatakeyama, Shingo and Iwamura, Hiromichi and Fujita, Naoki and Fukushi, Ken and Narita, Takuma and Hagiwara, kazuhisa and Kusaka, Ayumu and Hosogoe, Shogo and Yamamoto, Hayato and Tobisawa, Yuki and Yoneyama, Tohru and Yoneyama, Takahiro and Hashimoto, Yasuhiro and Koie, Takuya and Ito, Hiroyuki and Yoshikawa, Kazuaki and Kawaguchi, Toshiaki and Ohyama, Chikara},
 issue = {37},
 journal = {ONCOTARGET},
 month = {Sep},
 note = {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.},
 pages = {61404--61414},
 title = {Preoperative chronic kidney disease predicts poor oncological outcomes after radical cystectomy in patients with muscle-invasive bladder cancer},
 volume = {8},
 year = {2017}
}