Predictive and Prognostic Value of Preoperative Thrombocytosis in Upper Tract Urothelial Carcinoma
Standard
Predictive and Prognostic Value of Preoperative Thrombocytosis in Upper Tract Urothelial Carcinoma. / Foerster, Beat; Moschini, Marco; Abufaraj, Mohammad; Soria, Francesco; Gust, Kilian M; Rouprêt, Morgan; Karakiewicz, Pierre I; Briganti, Alberto; Rink, Michael; Kluth, Luis; Mathieu, Romain; Margulis, Vitaly; Lotan, Yair; Aziz, Atiqullah; John, Hubert; Shariat, Shahrokh F; UTUC Collaboration.
in: CLIN GENITOURIN CANC, Jahrgang 15, Nr. 6, 12.2017, S. e1039-e1045.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Predictive and Prognostic Value of Preoperative Thrombocytosis in Upper Tract Urothelial Carcinoma
AU - Foerster, Beat
AU - Moschini, Marco
AU - Abufaraj, Mohammad
AU - Soria, Francesco
AU - Gust, Kilian M
AU - Rouprêt, Morgan
AU - Karakiewicz, Pierre I
AU - Briganti, Alberto
AU - Rink, Michael
AU - Kluth, Luis
AU - Mathieu, Romain
AU - Margulis, Vitaly
AU - Lotan, Yair
AU - Aziz, Atiqullah
AU - John, Hubert
AU - Shariat, Shahrokh F
AU - UTUC Collaboration
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - PURPOSE: The purpose of this study was to evaluate the predictive and prognostic role of preoperative thrombocytosis (TC) in upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) in a large multi-institutional cohort of patients.METHODS: Records of 2492 patients undergoing RNU for non-metastatic UTUC between 1990 and 2008 were retrospectively analyzed. Preoperative TC was defined as a platelet count > 400 × 109/L, irrespective of gender type. Logistic regression analyses were performed to evaluate its association with pathologic features. Cox proportional hazards regression was used for estimation of recurrence-free survival, cancer-specific survival, and overall survival.RESULTS: Preoperative TC was found in 309 (12.4%) patients and was associated with advanced tumor stage and grade, lymph node metastasis, lymphovascular invasion, tumor architecture, necrosis, and concomitant carcinoma in situ (P-values ≤ .027). Preoperative TC independently predicted ≥ pT2 (P < .001), non-organ-confined (P < .001), and lymph node-positive (P < .001) disease in a preoperative model that adjusted for the effects of age, gender, location, multifocality, and tumor architecture. Within a median follow-up of 45 months, recurrence occurred in 663 (26.6%) patients with 545 (21.9%) dying of UTUC. In univariable Cox proportional hazard regression analysis, TC was significantly associated with recurrence-free survival (hazard ratio [HR], 1.32; P = .015) and overall survival (HR, 1.4; P < .001), but not cancer-specific survival (HR, 1.17; P = .2). In both pre- and postoperative multivariable models, when adjusted for the effects of standard clinicopathologic features, TC did not retain its association with survival outcomes.CONCLUSIONS: Preoperative TC is associated with adverse clinicopathologic features and predicts worse pathology at RNU. Among other serum biomarkers, TC could benefit preoperative risk stratification and help guide treatment decisions.
AB - PURPOSE: The purpose of this study was to evaluate the predictive and prognostic role of preoperative thrombocytosis (TC) in upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) in a large multi-institutional cohort of patients.METHODS: Records of 2492 patients undergoing RNU for non-metastatic UTUC between 1990 and 2008 were retrospectively analyzed. Preoperative TC was defined as a platelet count > 400 × 109/L, irrespective of gender type. Logistic regression analyses were performed to evaluate its association with pathologic features. Cox proportional hazards regression was used for estimation of recurrence-free survival, cancer-specific survival, and overall survival.RESULTS: Preoperative TC was found in 309 (12.4%) patients and was associated with advanced tumor stage and grade, lymph node metastasis, lymphovascular invasion, tumor architecture, necrosis, and concomitant carcinoma in situ (P-values ≤ .027). Preoperative TC independently predicted ≥ pT2 (P < .001), non-organ-confined (P < .001), and lymph node-positive (P < .001) disease in a preoperative model that adjusted for the effects of age, gender, location, multifocality, and tumor architecture. Within a median follow-up of 45 months, recurrence occurred in 663 (26.6%) patients with 545 (21.9%) dying of UTUC. In univariable Cox proportional hazard regression analysis, TC was significantly associated with recurrence-free survival (hazard ratio [HR], 1.32; P = .015) and overall survival (HR, 1.4; P < .001), but not cancer-specific survival (HR, 1.17; P = .2). In both pre- and postoperative multivariable models, when adjusted for the effects of standard clinicopathologic features, TC did not retain its association with survival outcomes.CONCLUSIONS: Preoperative TC is associated with adverse clinicopathologic features and predicts worse pathology at RNU. Among other serum biomarkers, TC could benefit preoperative risk stratification and help guide treatment decisions.
KW - Aged
KW - Carcinoma, Transitional Cell
KW - Disease-Free Survival
KW - Female
KW - Humans
KW - Logistic Models
KW - Lymphatic Metastasis
KW - Male
KW - Middle Aged
KW - Nephroureterectomy
KW - Preoperative Period
KW - Prognosis
KW - Retrospective Studies
KW - Survival Analysis
KW - Thrombocytosis
KW - Treatment Outcome
KW - Urologic Neoplasms
KW - Journal Article
KW - Multicenter Study
U2 - 10.1016/j.clgc.2017.06.003
DO - 10.1016/j.clgc.2017.06.003
M3 - SCORING: Journal article
C2 - 28694147
VL - 15
SP - e1039-e1045
JO - CLIN GENITOURIN CANC
JF - CLIN GENITOURIN CANC
SN - 1558-7673
IS - 6
ER -
