Mp34-19 Effect of Histological Variants on the Outcomes of Radical Cystectomy for Non-metastatic Muscle-invasive Urinary Bladder Cancer
Year: 2017
Type: article
Study design: Observational Study
Abstract: explored the prognostic role of serum GGT in advanced urothelial carcinoma (aUC) patients.METHODS: This retrospective study included 126 consecutive aUC patients (inoperable cT4 and/or metastases to lymph nodes/distant organs) treated at a single cancer center from 2004 to 2016.Of the 126 patients, 93 (74%) received systemic chemotherapy.Variables collected included age, gender, performance status (PS), body mass index (BMI), hydronephrosis, primary site, lymph node/visceral metastasis, prior curative surgery, therapies for aUC, hemoglobin, white blood cell count, creatinine, albumin, alkaline phosphatase, lactate dehydrogenase (LDH), corrected calcium, C-reactive protein (CRP), aspartate/ alanine aminotransferase, and GGT.We assessed variables associated with overall survival (OS) using the Cox proportional hazards model.RESULTS: The median (range) serum GGT was 26 (7-252) U/L.During follow-up (median 12M), 92 patients died (2Y OS rate 24%).On multivariate analysis, GGT was an independent predictor for OS (HR 1.01 as a continuous variable, p ¼ 0.007) along with age (HR 1.04, p ¼ 0.003), BMI (HR 0.92, p ¼ 0.005), visceral metastasis (HR 1.92, p ¼ 0.006), albumin (HR 0.49, p ¼ 0.032), log LDH (HR 2.63, p < 0.001), and log CRP (HR 1.41, p < 0.001).Next, the optimal cut-off of GGT was determined.When patients with GGT 43 U/L were defined as elevated, HR was highest on univariate Cox proportional hazards analysis (2.16).The 2Y OS rates for patients with elevated and nonelevated GGT were 5% and 30%, respectively (p < 0.001).The prognostic significance of elevated GGT was confirmed in multivariate analysis (HR 2.29, p ¼ 0.001).Incorporation of GGT into the Bajorin 0 s model (PS and visceral metastasis) improved the c-index from 0.654 to 0.685.CONCLUSIONS: This study is the first to demonstrate the prognostic significance of serum GGT in aUC patients.
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2604816518