Objective: We aimed to investigate the pre- dictive value of additional parameters that may improve diagnostic accuracy in predicting ex- travesical tumor invasion in patients with muscle invasive transitional cell carcinoma after transure- thral bladder tumor resection (TUR-BT).
Material and Methods: The data of patients with muscle-invasive bladder tumor pathology on TUR-BT and who underwent radical cystectomy between January 2009 and December 2016 due to clinical stage T2 or T3 were evaluated retrospec- tively. Demographic, pathological and clinical da- tas were recorded. Patients were divided into two groups after pathological staging following radical cystectomy: 26 patients without extravesical tu- mor invasion (pT2) and 17 patients with extraves- ical tumor invasion (pT3).
Results: Of the patients with a median age of 65, 40 (93%) were male and 3 (7%) were female. ECOG score, ASA score, Charlson comorbidity index (CCI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio(PLR), monocyte/lym- phocyte ratio(MLR), mean platelet volume(MPV), presence of preoperative hydronephrosis, con- comitant carcinoma in situ(CIS), lymphovascular invasion(LVI), depth of invasion in muscularis propria >50%, history of previous tumor recur- rence were significantly higher in Group II. How- ever, estimated glomerular filtration rate (eGFR) was significantly lower. In multivariate analysis, hydronephrosis, previous recurrence, presence of LVI, depth of invasion in muscularis propria >50%, eGFR, NLR, PLR and MLR were found to be independent predictors in predicting ex- travesical invasion. According to ROC analysis, cut-off values for eGFR, MLR, PLR, NLR were 77.73 (AUC:0.805, p=0.001), 0.24 (AUC:0.771, p=0.003), 116 (AUC:0.766, p=0.004), 2.07 (AUC:0.710, p=0.021), respectively.Conclusions: Despite all the many advances in technology, long-term encrusted stents lead to sepsis and loss of kidney function. We think that not forgetting is the best means of protection against encrusted stent-related complications.
Conclusion: We think that diagnostic accuracy in clinical staging before radical cystectomy may be improved by using ad- ditional parameters other than CT or MRG.
Keywords: clinical staging, extravesical tumor invasion, muscle invasive bladder cancer, serum hemogram parameters
Abstract
Objective: We aimed to investigate the pre- dictive value of additional parameters that may improve diagnostic accuracy in predicting ex- travesical tumor invasion in patients with muscle invasive transitional cell carcinoma after transure- thral bladder tumor resection (TUR-BT).
Material and Methods: The data of patients with muscle-invasive bladder tumor pathology on TUR-BT and who underwent radical cystectomy between January 2009 and December 2016 due to clinical stage T2 or T3 were evaluated retrospec- tively. Demographic, pathological and clinical da- tas were recorded. Patients were divided into two groups after pathological staging following radical cystectomy: 26 patients without extravesical tu- mor invasion (pT2) and 17 patients with extraves- ical tumor invasion (pT3).
Results: Of the patients with a median age of 65, 40 (93%) were male and 3 (7%) were female. ECOG score, ASA score, Charlson comorbidity index (CCI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio(PLR), monocyte/lym- phocyte ratio(MLR), mean platelet volume(MPV), presence of preoperative hydronephrosis, con- comitant carcinoma in situ(CIS), lymphovascular invasion(LVI), depth of invasion in muscularis propria >50%, history of previous tumor recur- rence were significantly higher in Group II. How- ever, estimated glomerular filtration rate (eGFR) was significantly lower. In multivariate analysis, hydronephrosis, previous recurrence, presence of LVI, depth of invasion in muscularis propria >50%, eGFR, NLR, PLR and MLR were found to be independent predictors in predicting ex- travesical invasion. According to ROC analysis, cut-off values for eGFR, MLR, PLR, NLR were 77.73 (AUC:0.805, p=0.001), 0.24 (AUC:0.771, p=0.003), 116 (AUC:0.766, p=0.004), 2.07 (AUC:0.710, p=0.021), respectively.Conclusions: Despite all the many advances in technology, long-term encrusted stents lead to sepsis and loss of kidney function. We think that not forgetting is the best means of protection against encrusted stent-related complications.
Conclusion: We think that diagnostic accuracy in clinical staging before radical cystectomy may be improved by using ad- ditional parameters other than CT or MRG.
Keywords: clinical staging, extravesical tumor invasion, muscle invasive bladder cancer, serum hemogram parameters