Determinants of survival in patients with bladder cancer undergoing radical cystectomy: The impact of serum creatinine level.

Bladder cancer is one of the most common cancers in Europe and is mostly found in men. Cystectomy is the treatment for invasive tumors that infiltrate the muscle of the bladder. This procedure is associated with a large number of complications. Eligibility for surgical treatment is important, because surgery may shorten the patient's life. The main prognostic factor is the severity of the disease, but less specific factors can be very helpful in selecting the form of treatment.

To identify and analyze factors affecting significantly the survival in patients undergoing radical cystectomy (RC).

A retrospective analysis of a group of 129 patients treated at the Department of Urology and Urological Oncology of University Hospital in Wrocław (Poland) was carried out. Furthermore, information about the results of laboratory tests from the medical records (blood count, creatinine concentration, etc.) was obtained. The follow-up was performed twice during the postoperative period. The Kaplan-Meier method was used to determine overall survival (OS) curves and statistical significance was assessed using log-rank test.

A statistically significant correlation between preoperative serum creatinine level and OS was found. The OS was significantly shorter in patients with higher serum creatinine levels (log-rank test; p = 0.002). The patients were divided into different groups to exclude the relationship between the elevated creatinine concentration and the local disease advancement. The analysis was performed in patients with and without hydronephrosis. In both groups, creatinine levels above the acceptable range were associated with a shorter survival.

Due to the high perioperative mortality, mainly in patients with advanced disease, it is necessary to develop the qualification process for surgical treatment. The awareness of the relationship between elevated creatinine levels and worse prognosis seems to be helpful.

Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 2021 Jan [Epub]

Paweł Hackemer, Bartosz Małkiewicz, Fryderyk Menzel, Aleksandra Drabik, Krzysztof Tupikowski, Romuald Zdrojowy

Department of Urology and Oncologic Urology, Wroclaw Medical University, Poland., Department of Hygiene, Wroclaw Medical University, Poland., Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Poland., Department of Urology, Lower Silesian Oncology Center, Wrocław, Poland.

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