While preoperative predictors have been extensively studied, the prognostic impact of postoperative clinical and laboratory factors on overall survival in patients following radical cystectomy remains relatively unknown. While this study attempts to answer this important question, the length of followup and the short term nature of the results call the conclusion into question. Immediate postoperative fluctuation in laboratory values can be due to a host of different reasons: patients’ comorbidities, inflammation arising from surgery, or the biology of the patients’ disease. Although intriguing, the link between inferior postoperative renal function and inflammation with poor survival need to be further explored. Rather than using the two laboratory values as a one-size-fits-all postoperative predictor, the different processes associated with abnormal lab values need to be elucidated. Postoperative complications may also be a surrogate for frailty, immunodeficiency, or other factors known to adversely affect outcome. Furthermore, the study may be strengthened by using the changes in the laboratory values rather than the absolute postoperative value as the predictor.
Presenter: Jan-Friedrich Jokisch, MD
Written By: Roger Li MD Urologic Oncology Fellow, UT MD Anderson Cancer Center
Ashish M. Kamat MD Wayne B. Duddlesten Professor, UT MD Anderson Cancer Center
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA