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Impact of stage and comorbidities on five-year survival after radical cystectomy in Poland: single centre experience.

Dybowski B, Ossoliński K, Ossolińska A, Peller M, Bres-Niewada E, Radziszewski P - Cent European J Urol (2015)

Bottom Line: However, a composite parameter consisting of stage, diabetes status and postoperative course was found as a significant predictor.Five-year OS in our group was lower than in most published international series but concordant with a previous Polish report.Improvement in survival after radical cystectomy may be expected when early diagnosis will be accompanied by optimal care of patients with diabetes mellitus and avoidance of postoperative complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Warsaw, Poland.

ABSTRACT

Introduction: Long-term outcomes of patients treated for invasive bladder cancer in Poland are poorly documented in the literature. Impact of various clinical parameters on their survival is even less well studied. Radical cystectomy is a major surgery, so the patients' condition can be equally important as cancer stage. The aim of the study was to assess 5-year overall survival (OS) after cystectomy and impact of comorbidity on OS in a single Polish academic centre.

Material and methods: Clinical data of all patients who underwent cystectomy in years 2004-2006 for urothelial cancer were retrospectively reviewed. Survival status was determined at least 5 years after surgery. Pathological variables, comorbidities, surgery delay and complications were evaluated as potential predictors of OS. Kaplan-Meier estimates of the survival function as well as Cox proportional hazards models were utilized.

Results: Thirty-day, 1-year and 5-year OS for 63 patients was 98.4%, 58.7% and 31.7%, respectively. None of the investigated parameters were significantly related to five-year OS. However, a composite parameter consisting of stage, diabetes status and postoperative course was found as a significant predictor. Five-year OS in 16 patients with pT1-2 and without diabetes and without post-operative complications was higher than in the remaining 47 patients (56% vs. 23%; P = 0.02).

Conclusions: Five-year OS in our group was lower than in most published international series but concordant with a previous Polish report. Improvement in survival after radical cystectomy may be expected when early diagnosis will be accompanied by optimal care of patients with diabetes mellitus and avoidance of postoperative complications.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curves depicting overall survival after radical cystectomy in patients with: pT1-2 tumours AND no diabetes mellitus (DM) AND no complications (n = 16) versus patients with: pT3-4 tumours OR DM OR complications (n = 47). The difference in survival is statistically significant (P = 0.02 in the log-rank test).
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Figure 0001: Kaplan-Meier curves depicting overall survival after radical cystectomy in patients with: pT1-2 tumours AND no diabetes mellitus (DM) AND no complications (n = 16) versus patients with: pT3-4 tumours OR DM OR complications (n = 47). The difference in survival is statistically significant (P = 0.02 in the log-rank test).

Mentions: Using Cox proportional hazards regression, a trend towards significance (P = 0.054) was found for the model consisting of the three variables with the lowest P values in univariate analysis: stage, diabetes mellitus status and postoperative complications. N-status was excluded for its lack of complete data. Nine of sixteen (56%) patients with stage pT1-2, without diabetes mellitus and without postoperative complications survived 5 years, while among 47 people with at least one of the adverse factors 5-yr survival was 23% (P = 0.02 in the log rank test; odds ratio 4.2, 95% confidence interval 1.3 – 13.9; Figure 1).


Impact of stage and comorbidities on five-year survival after radical cystectomy in Poland: single centre experience.

Dybowski B, Ossoliński K, Ossolińska A, Peller M, Bres-Niewada E, Radziszewski P - Cent European J Urol (2015)

Kaplan-Meier curves depicting overall survival after radical cystectomy in patients with: pT1-2 tumours AND no diabetes mellitus (DM) AND no complications (n = 16) versus patients with: pT3-4 tumours OR DM OR complications (n = 47). The difference in survival is statistically significant (P = 0.02 in the log-rank test).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4643711&req=5

Figure 0001: Kaplan-Meier curves depicting overall survival after radical cystectomy in patients with: pT1-2 tumours AND no diabetes mellitus (DM) AND no complications (n = 16) versus patients with: pT3-4 tumours OR DM OR complications (n = 47). The difference in survival is statistically significant (P = 0.02 in the log-rank test).
Mentions: Using Cox proportional hazards regression, a trend towards significance (P = 0.054) was found for the model consisting of the three variables with the lowest P values in univariate analysis: stage, diabetes mellitus status and postoperative complications. N-status was excluded for its lack of complete data. Nine of sixteen (56%) patients with stage pT1-2, without diabetes mellitus and without postoperative complications survived 5 years, while among 47 people with at least one of the adverse factors 5-yr survival was 23% (P = 0.02 in the log rank test; odds ratio 4.2, 95% confidence interval 1.3 – 13.9; Figure 1).

Bottom Line: However, a composite parameter consisting of stage, diabetes status and postoperative course was found as a significant predictor.Five-year OS in our group was lower than in most published international series but concordant with a previous Polish report.Improvement in survival after radical cystectomy may be expected when early diagnosis will be accompanied by optimal care of patients with diabetes mellitus and avoidance of postoperative complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Warsaw, Poland.

ABSTRACT

Introduction: Long-term outcomes of patients treated for invasive bladder cancer in Poland are poorly documented in the literature. Impact of various clinical parameters on their survival is even less well studied. Radical cystectomy is a major surgery, so the patients' condition can be equally important as cancer stage. The aim of the study was to assess 5-year overall survival (OS) after cystectomy and impact of comorbidity on OS in a single Polish academic centre.

Material and methods: Clinical data of all patients who underwent cystectomy in years 2004-2006 for urothelial cancer were retrospectively reviewed. Survival status was determined at least 5 years after surgery. Pathological variables, comorbidities, surgery delay and complications were evaluated as potential predictors of OS. Kaplan-Meier estimates of the survival function as well as Cox proportional hazards models were utilized.

Results: Thirty-day, 1-year and 5-year OS for 63 patients was 98.4%, 58.7% and 31.7%, respectively. None of the investigated parameters were significantly related to five-year OS. However, a composite parameter consisting of stage, diabetes status and postoperative course was found as a significant predictor. Five-year OS in 16 patients with pT1-2 and without diabetes and without post-operative complications was higher than in the remaining 47 patients (56% vs. 23%; P = 0.02).

Conclusions: Five-year OS in our group was lower than in most published international series but concordant with a previous Polish report. Improvement in survival after radical cystectomy may be expected when early diagnosis will be accompanied by optimal care of patients with diabetes mellitus and avoidance of postoperative complications.

No MeSH data available.


Related in: MedlinePlus