Predictors of Intravesical Recurrence After Radical Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma: An Inflammation-Based Prognostic Score
조양현, 서영호, Chung Seung-Jun, 황인상, 유호송, 김선옥, 정승일, 강택원, 권동득, 박광성, 황의창, 황준일, 허숙희, 김근수,
소속 상세정보
조양현 ( Cho Yang-Hyun )
Chonnam National University Medical School Department of Urology
서영호 ( Seo Young-Ho )
Chonnam National University Medical School Department of Urology
( Chung Seung-Jun )
Chonnam National University Medical School Department of Urology
황인상 ( Hwang In-Sang )
Chonnam National University Medical School Department of Urology
유호송 ( Yu Ho-Song )
Chonnam National University Medical School Department of Urology
김선옥 ( Kim Sun-Ouck )
Chonnam National University Medical School Department of Urology
정승일 ( Jung Seung-Il )
Chonnam National University Medical School Department of Urology
강택원 ( Kang Taek-Won )
Chonnam National University Medical School Department of Urology
권동득 ( Kwon Dong-Deuk )
Chonnam National University Medical School Department of Urology
박광성 ( Park Kwang-Sung )
Chonnam National University Medical School Department of Urology
황의창 ( Hwang Eu-Chang )
Chonnam National University Medical School Department of Urology
황준일 ( Hwang Jun-Eul )
Chonnam National University Medical School Department of Hematology-Oncology
허숙희 ( Heo Suk-Hee )
Chonnam National University Medical School Department of Radiology
김근수 ( Kim Geun-Soo )
Gwangju Hospital Department of Urology
KMID : 0358320140550070453
Abstract
Purpose: Systemic inflammatory responses, which are defined in terms of the Glasgow prognostic score (GPS), have been reported to be independent predictors of unfavorable outcomes in various human cancers. We assessed the utility of the GPS as a predictor of intravesical recurrence after radical nephroureterectomy (RNU) in upper urinary tract carcinoma (UTUC).
Materials and Methods: We collected data for 147 UTUC patients with no previous history of bladder cancer who underwent RNU from 2004 to 2012. Associations between perioperative clinicopathological variables and intravesical recurrence were analyzed by using univariate and multivariate Cox regression models.
Results: Overall, 71 of 147 patients (48%) developed intravesical recurrence, including 21 patients (30%) diagnosed with synchronous bladder tumor. In the univariate analysis, performance status, diabetes mellitus (DM), serum albumin, C-reactive protein, GPS, and synchronous bladder tumor were associated with intravesical recurrence. In the multivariate analysis, performance status (hazard ratio [HR], 2.33; 95% confidence interval [CI], 1.41-3.85; p=0.001), DM (HR, 2.04; 95% CI, 1.21-3.41; p=0.007), cortical thinning (HR, 2.01; 95% CI, 1.08-3.71; p=0.026), and GPS (score of 1: HR, 6.86; 95% CI, 3.69-12.7; p=0.001; score of 2: HR, 5.96; 95% CI, 3.10-11.4; p=0.001) were independent predictors of intravesical recurrence.
Conclusions: Our results suggest that the GPS as well as performance status, DM, and cortical thinning are associated with intravesical recurrence after RNU. Thus, more careful follow-up, coupled with postoperative intravesical therapy to avoid bladder recurrence, should be considered in these patients.
키워드
Inflammation;Recurrence;Risk factors;Transitional cell carcinoma
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