Prognostic value of preoperative hydronephrosis in patients with bladder cancer undergoing radical cystectomy: A meta-analysis

Zhu, Zhaowei; Zhao, Jia; Li, Yinghui; Pang, Chen; Zhu, Zhanwei; Zhang, Xuepei

doi:10.1371/journal.pone.0222223

Cited by 21 publications

(17 citation statements)

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“…Even yet, using techniques like cross‐validation and optimal subset regression, the presence of preoperative hydronephrosis was identified as one of the most effective sets of factors. Preoperative hydronephrosis was proven to be a separate risk factor for survival following RC for bladder cancer in earlier research 3–5 . Preoperative hydronephrosis was thus incorporated into the model in this investigation.…”

Section: Resultsmentioning

confidence: 99%

Prognostic nutritional index combined with NLR to construct a survival prediction model and decision analysis of patients with muscle‐invasive bladder cancer after surgery

et al. 2023

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Objectives To build a nomogram prediction model, assess its predictive ability, and perform a survival decision analysis on patients with muscle‐invasive bladder cancer (MIBC) to study risk factors affecting overall survival (OS). Methods A retrospective analysis was performed on the clinical information of 262 patients with MIBC who underwent radical cystectomy (RC) at the Urology Department of the Second Affiliated Hospital of Kunming Medical University between July 2015 and August 2021. The final model variables that were included were chosen using single‐factor stepwise Cox regression, optimal subset regression, and LASSO regression + cross‐validation with the minimum AIC value. The next step was to do a multivariate Cox regression analysis. The establishment of a nomogram model by fitting and the screening out of independent risk factors impacting the survival of patients with MIBC having radical resection. Receiver Activity Characteristic curves, C‐index, and a calibration plot evaluated the prediction accuracy, validity, and clinical benefit of the model. The 1‐, 3‐, and 5‐year survival rates were then computed for each risk factor using a Kaplan–Meier survival analysis. Results 262 eligible patients in total were enrolled. With a median follow‐up of 32 months, the follow‐up period ranged from 2 to 83 months. 171 cases (65.27%) survived while 91 cases (34.73%) perished. Age (HR = 1.06 [1.04; 1.08], p = 0.001), preoperative hydronephrosis (HR = 0.69 [0.46, 1.05], p = 0.087), T stage (HR = 2.06 [1.09, 3.93], p = 0.027), lymphovascular invasion (LVI, HR = 1.73 [1.12, 2.67], p = 0.013), prognostic nutritional index (PNI, HR = 1.70 [1.09, 2.63], p = 0.018), and neutrophil‐to‐lymphocyte ratio (NLR, HR = 0.52 [0.29, 0.93)], p = 0.026) were independent risk factor for the survival of bladder cancer patients. Create a nomogram based on the aforementioned findings, and then draw the 1‐year, 3‐year, and 5‐year OS receiver operating characteristic curves by the nomogram. The AUC values were 0.811 (95% CI [0.752, 0.869]), 0.814 (95% CI [0.755, 0.873]), and 0.787 (95% CI [0.708, 0.865]), respectively, and the calibration plot matched the predicted value well. The 1‐year, 3‐year, and 5‐year decision curve analyses were higher than the ALL line and None line at threshold values of >5%, 5%–70%, and 20%–70% indicating that the model has good clinical applicability. The calibration plot for the Bootstrap 1000‐time resampled validation model was similar to the actual value. Patients with preoperative combination hydronephrosis, higher T‐stage, combined LVI, low PNI, and high NLR had worse survival, according to Kaplan–Meier survival analysis for each variable. Conclusions This study might conclude that PNI and NLR were separate risk factors that affect a patient's OS after RC for MIBC. The prognosis of bladder cancer may be predicted by PNI and NLR, but additional confirmation in randomized controlled trials is required.

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Section: Resultsmentioning

confidence: 99%

Prognostic nutritional index combined with NLR to construct a survival prediction model and decision analysis of patients with muscle‐invasive bladder cancer after surgery

et al. 2023

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“…Each variable in our model was independently associated with patients' survival and consistent with prior studies. Zhu et al [22] found that preoperative hydronephrosis is signi cantly associated with poorer OS and CSS after radical cystectomy for patients with BC. Bartsch et al [23]discovered that 133 patients (16.9%) had hydronephrosis before surgery when conducting a prognostic analysis on 788 patients who recieved radical cystectomy for BC.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Prognostic Nomogram in Patients with Bladder Cancer after Radical Cystectomy: A Study Based on the Chinese Population

Wang¹,

Chen²,

Xia³

et al. 2021

Preprint

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PurposeTo develop and validate a prognostic nomogram in patients with bladder cancer who underwent radical cystectomy based on the Chinese population.MethodsThe nomogram was built on a retrospective study included 191 patients with bladder cancer who underwent radical cystectomy between January 2010 to December 2019 at the authors’ hospital. The primary cohort was divided into the training cohort and the validation cohort randomly. The endpoints in the study were disease-free survival and overall survival. The ability of distinguishing and predicting of the prognostic nomogram were determined by calibration plot and concordance index in the training cohort. Moreover, the results were also verified in the validation cohort internally.ResultsMultivariate analysis of the training cohort showed that hydronephrosis, Stage_T, Stage_N, PNI and EGFR were significantly associated with overall survival. Meanwhile, Stage_T, Stage_N, PNI and EGFR were independent risk factors for disease-free survival. The calibration plot agreed well between prediction and actual observation in survival possibility. The concordance index of the nomogram in the training cohort of overall survival and disease-free survival were 0.834 (95%CI: 0.785-0.833) and 0.823 (95%CI: 0.772-0.873), respectively. In the validation cohort, the nomogram also showed high predictive accuracy.ConclusionThe proposed nomogram showed high accuracy in predicting survival for bladder cancer patients after radical cystectomy.

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“…Approximately 27% of patients with muscle invasive bladder cancer present with hydronephrosis prior to cystectomy, and chronic kidney disease (CKD) patients have been shown to have significantly higher rates of multifocal UCC/UTUC. [7][8][9] The risk of UTUC in ESRD patients is so high, approaching 50-fold higher than seen in the general population in some nations, that prophylactic bilateral nephroureterectomy of the non-functioning renal units may be considered even in the absence of UTUC when cystectomy is indicated. 8,9 Still, there are relatively low proportions of patients who have severe enough pathology of both the upper and lower tracts to warrant simultaneous RC+RNU, which has hampered adequate characterization of patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of patients undergoing concurrent radical cystectomy and nephroureterectomy: A single-institution series

Carpinito

Cook

Tverye

et al. 2022

CUAJ

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Introduction: Radical cystectomy (RC) and radical nephroureterectomy (RNU) are commonly performed in urological oncology. Concurrent disease in the upper tract and bladder is rare, so performing both procedures in the same setting is uncommon. Here, we report the perioperative and oncological outcomes of a single-institution series of concurrent RC+RNU. Methods: We retrospectively reviewed the charts of patients who underwent concurrent RC+RNU for bladder and/or upper tract urothelial carcinoma between 2006 and 2020. Patient demographic and clinical factors, perioperative parameters, and oncological outcomes were obtained. Results: Twenty-seven patients underwent RC+RNU during the study period; 22 (81%) were male. Median (interquartile range) patient age was 71 (67–75) years. All had a diagnosis of bladder cancer. Concurrent upper tract urothelial carcinoma (UTUC) was the indication for RNU in 12 cases (44%) and non-functional renal unit in the remainder. Two patients (7%) experienced early postoperative mortality. Eight patients (30%) experienced major complications (Clavien-Dindo >3). Complications did not vary significantly between those rendered anephric (5/16, 31%) and those who were not (3/11, 27%) (p=0.82, Chi-squared test). Median (95% confidence interval) and five-year overall survival were 47 (41–52) months and 42%, respectively. Six of 22 male patients (27%) experienced a urethral recurrence and three of 14 patients (21%) with non-functional kidneys had occult UTUC discovered on final pathology. Conclusions: Combined RC+RNU carries an elevated perioperative risk, primarily in highly comorbid patients. Striking rates of occult UTUC in non-functional kidneys and of urethral recurrence after cystectomy were noted. RC+RNU is an appropriate option in select patients.

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Prognostic value of preoperative hydronephrosis in patients with bladder cancer undergoing radical cystectomy: A meta-analysis

Cited by 21 publications

References 30 publications

Prognostic nutritional index combined with NLR to construct a survival prediction model and decision analysis of patients with muscle‐invasive bladder cancer after surgery

Prognostic nutritional index combined with NLR to construct a survival prediction model and decision analysis of patients with muscle‐invasive bladder cancer after surgery

Development and Validation of a Prognostic Nomogram in Patients with Bladder Cancer after Radical Cystectomy: A Study Based on the Chinese Population

Outcomes of patients undergoing concurrent radical cystectomy and nephroureterectomy: A single-institution series

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Prognostic value of preoperative hydronephrosis in patients with bladder cancer undergoing radical cystectomy: A meta-analysis

Cited by 21 publications

References 30 publications

Prognostic nutritional index combined with NLR to construct a survival prediction model and decision analysis of patients with muscle‐invasive bladder cancer after surgery

Prognostic nutritional index combined with NLR to construct a survival prediction model and decision analysis of patients with muscle‐invasive bladder cancer after surgery

Development and Validation of a Prognostic Nomogram in&nbsp;Patients with Bladder Cancer after Radical Cystectomy: A Study Based on the Chinese Population

Outcomes of patients undergoing concurrent radical cystectomy and nephroureterectomy: A single-institution series

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Development and Validation of a Prognostic Nomogram in Patients with Bladder Cancer after Radical Cystectomy: A Study Based on the Chinese Population