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Yamane H, Morizane S, Honda M, Muraoka K, Oono H, Isoyama T, Ono K, Sejima T, Kadowaki H, Takenaka A. Preoperative risk stratification models after radical cystectomy for bladder cancer: A multi-center study. Int J Urol 2024. [PMID: 39140229 DOI: 10.1111/iju.15560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE We investigated preoperative patient factors associated with prognosis in 263 bladder cancer (BC) patients undergoing radical cystectomy (RC). We also developed new risk stratification models for prognosis. METHODS This retrospective study included patients treated at Tottori University Hospital and affiliated hospitals between January 2010 and December 2019. The relationship between preoperative patient factors and overall recurrence-free and cancer-specific survival (CSS) was analyzed. The modified Glasgow prognosis score (mGPS) was calculated using serum albumin and C-reactive protein (CRP) levels. Statistical analyses included the log-rank test and Cox proportional hazards regression. RESULTS Eastern Cooperative Oncology Group performance status (ECOG-PS), mGPS, and clinical tumor stage independently predicted CSS in multivariate analysis. A new risk stratification model included ECOG-PS ≥2, clinical tumor stage ≥3, serum albumin <3.5 g/dL, and serum CRP >0.5 mg/dL. Risk groups were defined as 0 factors (low risk), 1-2 factors (intermediate risk), and 3-4 factors (high risk). High-risk patients showed significantly poorer 3-year cancer-free survival: 86.9% (low risk), 76.7% (intermediate risk), and 50.0% (high risk). CONCLUSIONS ECOG-PS, clinical tumor stage, and mGPS are predictive of poor cancer-free survival post-RC for BC. Our model offers the potential for prognostic prediction in these patients.
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Affiliation(s)
- Hiroshi Yamane
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Shuichi Morizane
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Masashi Honda
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Kuniyasu Muraoka
- Department of Urology, Tottori Prefectural Central Hospital, Tottori, Tottori, Japan
| | - Hirofumi Oono
- Department of Urology, Japanese Red Cross Matsue Hospital, Matsue, Shimane, Japan
| | - Tadahiro Isoyama
- Department of Urology, Yonago Medical Center, Yonago, Tottori, Japan
| | - Koji Ono
- Department of Urology, Japanese Red Cross Tottori Hospital, Tottori, Tottori, Japan
| | - Takehiro Sejima
- Department of Urology, Matsue City Hospital, Matsue, Shimane, Japan
| | | | - Atsushi Takenaka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
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Pan W, Liu X, Liu S. ALYREF m5C RNA methylation reader predicts bladder cancer prognosis by regulating the tumor immune microenvironment. Medicine (Baltimore) 2024; 103:e37590. [PMID: 38579085 PMCID: PMC10994465 DOI: 10.1097/md.0000000000037590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/22/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND 5-Methylcytidine (m5C) methylation is a recently emerging epigenetic modification that is closely related to tumor proliferation, occurrence, and metastasis. This study aimed to investigate the clinicopathological characteristics and prognostic value of m5C regulators in bladder cancer (BLCA), and their correlation with the tumor immune microenvironment. METHODS Thirteen m5C RNA methylation regulators were analyzed using RNA-sequencing and corresponding clinical information obtained from the TCGA database. The Cluster Profiler package was used to analyze the gene ontology function of potential targets and enriched the Kyoto Encyclopedia of Genes and Genomes pathway. Kaplan-Meier survival analysis was used to compare survival differences using the log-rank test and univariate Cox proportional hazards regression. The correlation between signature prognostic m5C regulators and various immune cells was analyzed. Univariate and multivariate Cox regression analyses identified independence of the ALYREF gene signature. RESULTS Nine out of the 13 m5C RNA methylation regulators were differentially expressed in BLCA and normal samples and were co-expressed. These 9 regulators were associated with clinicopathological tumor characteristics, particularly high or low tumor risk, pT or pTNM stage, and migration. Consensus clustering analysis divides the BLCA samples into 4 clusters. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment annotation and gene ontology function analysis identified 273 upregulated and 594 downregulated genes in BLCA. Notably, only ALYREF was significantly correlated with OS (P < .05). ALYREF exhibited significant infiltration levels in macrophage cells. Therefore, we constructed a nomogram for ALYREF as an independent prognostic factor. Additionally, we observed that both the mRNA and protein levels of ALYREF were upregulated, and immunofluorescence showed that ALYREF was mainly distributed in nuclear speckles. ALYREF overexpression was significantly associated with poor OS. CONCLUSION Our findings demonstrated the potential of ALYREF to predict clinical prognostic risks in BLCA patients and regulate the tumor immune microenvironment. As such, ALYREF may serve as a novel prognostic indicator in BLCA patients.
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Affiliation(s)
- Wengu Pan
- Kidney Transplantation of The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Kidney Transplantation, Multidisciplinary Innovation Center for Nephrology, The Second Hospital of Shandong University, Jinan, China
| | - Xiaoli Liu
- Kidney Transplantation of The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Kidney Transplantation, Multidisciplinary Innovation Center for Nephrology, The Second Hospital of Shandong University, Jinan, China
| | - Shuangde Liu
- Kidney Transplantation of The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Kidney Transplantation, Multidisciplinary Innovation Center for Nephrology, The Second Hospital of Shandong University, Jinan, China
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Xu H, Sun D, Zhou D, Sun S. Immune Cell Infiltration Types as Biomarkers for the Recurrence Diagnosis and Prognosis of Bladder Cancer. Cancer Invest 2024; 42:186-198. [PMID: 38390837 DOI: 10.1080/07357907.2024.2308161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 01/17/2024] [Indexed: 02/24/2024]
Abstract
This study aimed to investigate the role of infiltrating immune cell types in diagnosing and predicting bladder cancer recurrence. This study mainly applied some algorithms, including Estimate the Proportion of Immune and Cancer Cells (EPIC), support vector machine-recursive feature elimination (SVM-RFE), random forest out-of-bag (RF-OOB) and least absolute shrinkage and selection operator (LASSO)-Cox regression analysis. We found six immune infiltrating cell types significantly associated with recurrence prognosis and two independent clinical prognostic factors. Infiltrating immune cell types (IICTs) based on the prognostic immune risk score (pIRS) models may provide significant biomarkers for the diagnosis and prognostic prediction of bladder cancer recurrence.
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Affiliation(s)
- Hongwei Xu
- Urology Department, Heilongjiang Provincial Hospital, Harbin City, Heilongjiang Province, China
| | - Dapeng Sun
- Urology Department, Heilongjiang Provincial Hospital, Harbin City, Heilongjiang Province, China
| | - Dahong Zhou
- Urology Department, Heilongjiang Provincial Hospital, Harbin City, Heilongjiang Province, China
| | - Shiheng Sun
- Urology Department, Heilongjiang Provincial Hospital, Harbin City, Heilongjiang Province, China
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Peng C, Guo S, Yang Z, Li X, Su Q, Mo W. A prognostic model for bladder cancer based on cytoskeleton-related genes. Medicine (Baltimore) 2023; 102:e33538. [PMID: 37115085 PMCID: PMC10146030 DOI: 10.1097/md.0000000000033538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND A typical cancerous growth in the urinary tract, bladder cancer (BLCA) has a dismal survival rate and a poor chance of being cured. The cytoskeleton has been shown to be tightly related to tumor invasion and metastasis. Nevertheless, the expression of genes associated with the cytoskeleton and their prognostic significance in BLCA remain unknown. METHODS In our study, we performed differential expression analysis of cytoskeleton-related genes between BLCA versus normal bladder tissues. According to the outcomes of this analysis of differentially expressed genes, all BLCA cases doing nonnegative matrix decomposition clustering analysis be classified into different molecular subtypes and were subjected to Immune cell infiltration analysis. We then constructed a cytoskeleton-associated gene prediction model for BLCA, and performed risk score independent prognostic analysis and receiver operating characteristic curve analyses to evaluate and validate the prognostic value of the model. Furthermore, enrichment analysis, clinical correlation analysis of prognostic models, and immune cell correlation analysis were carried out. RESULTS We identified 546 differentially expressed genes that are linked to the cytoskeleton, including 314 up-regulated genes and 232 down-regulated genes. All BLCA cases doing nonnegative matrix decomposition clustering analysis could be classified into 2 molecular subtypes, and we observed differences (P < .05) in C1 and C2 immune scores about 9 cell types. Next, we obtained 129 significantly expressed cytoskeleton-related genes. A final optimized model was constructed consisting of 11 cytoskeleton-related genes. Survival curves and risk assessment predicted the prognostic risk in both groups of patients with BLCA. Survival curves and receiver operating characteristic curves were used to evaluate and validate the prognostic value of the model. Significant enrichment pathways for cytoskeleton-associated genes in bladder cancer samples were explored by Gene set enrichment analysis enrichment analysis. After we obtained the risk scores, a clinical correlation analysis was performed to examine which clinical traits were related to the risk scores. Finally, we demonstrated a correlation between different immune cells. CONCLUSION Cytoskeleton-related genes have an important predictive value for BLCA, and the prognostic model we constructed may enable personalized treatment of BLCA.
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Affiliation(s)
- Chunting Peng
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang, China
| | - Sufan Guo
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang, China
| | - Zheng Yang
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang, China
| | - Xiaohong Li
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang, China
| | - Qisheng Su
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang, China
| | - Wuning Mo
- Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang, China
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Tan D, Li J, Lin T, Tan P, Zhang J, Xiong Q, Jiang J, Li Y, Zhang P, Wei Q. Prognostic Utility of the Modified Glasgow Prognostic Score in Urothelial Carcinoma: Outcomes from a Pooled Analysis. J Clin Med 2022; 11:jcm11216261. [PMID: 36362488 PMCID: PMC9655933 DOI: 10.3390/jcm11216261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Many studies explored the prognostic value of the modified Glasgow Prognostic Score (mGPS) in urothelial carcinoma (UC), but the results are controversial. This study aimed to quantify the relationship between pretreatment mGPS and survival in patients with UC. Methods: A systematic literature search was conducted using Embase, PubMed, and Web of Science to identify eligible studies published before August 2022. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the association between pretreatment mGPS and the prognosis of UC. Results: Thirteen eligible studies involving 12,524 patients were included. A high mGPS was significantly associated with poor overall survival (mGPS 1/0: HR = 1.33, 95% CI 1.12−1.58, p = 0.001; mGPS 2/0: HR = 2.02, 95% CI 1.43−2.84, p < 0.0001), progression-free survival (mGPS 1/0: HR = 1.26, 95% CI 1.03−1.53, p = 0.021; mGPS 2/0: HR = 1.76, 95% CI 1.12−2.77, p = 0.013), recurrence-free survival (mGPS 1/0: HR = 1.36, 95% CI 1.18−1.56, p < 0.0001; mGPS 2/0: HR = 1.70, 95% CI 1.44−2.000, p < 0.0001), and cancer-specific survival (mGPS 2/0: HR = 1.81, 95% CI 1.30−2.52, p < 0.0001). A subgroup analysis of OS also yielded similar results. Conclusions: Evidence suggests that high pretreatment mGPS in UC is closely related to poor survival. Pre-treatment mGPS is a powerful independent prognostic factor in patients with UC.
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Affiliation(s)
- Daqing Tan
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Urology, Minda Hospital of Hubei Minzu University, Enshi 445000, China
| | - Jinze Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Tianhai Lin
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ping Tan
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jiapeng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiao Xiong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jinjiang Jiang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yifan Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Peng Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (P.Z.); (Q.W.)
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (P.Z.); (Q.W.)
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Uchimoto T, Nakamura K, Komura K, Fukuokaya W, Yano Y, Nishimura K, Kinoshita S, Nishio K, Fukushima T, Nakamori K, Matsunaga T, Tsutsumi T, Tsujino T, Taniguchi K, Tanaka T, Uehara H, Takahara K, Inamoto T, Kimura T, Egawa S, Azuma H. Prognostic value of the fluctuation in the neutrophil–lymphocyte ratio at 6 weeks of pembrolizumab treatment is specific to the clinical response in metastatic urothelial carcinoma. Urol Oncol 2022; 40:344.e11-344.e17. [DOI: 10.1016/j.urolonc.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/12/2022] [Accepted: 02/06/2022] [Indexed: 11/27/2022]
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di Meo NA, Loizzo D, Pandolfo SD, Autorino R, Ferro M, Porta C, Stella A, Bizzoca C, Vincenti L, Crocetto F, Tataru OS, Rutigliano M, Battaglia M, Ditonno P, Lucarelli G. Metabolomic Approaches for Detection and Identification of Biomarkers and Altered Pathways in Bladder Cancer. Int J Mol Sci 2022; 23:ijms23084173. [PMID: 35456991 PMCID: PMC9030452 DOI: 10.3390/ijms23084173] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 12/24/2022] Open
Abstract
Metabolomic analysis has proven to be a useful tool in biomarker discovery and the molecular classification of cancers. In order to find new biomarkers, and to better understand its pathological behavior, bladder cancer also has been studied using a metabolomics approach. In this article, we review the literature on metabolomic studies of bladder cancer, focusing on the different available samples (urine, blood, tissue samples) used to perform the studies and their relative findings. Moreover, the multi-omic approach in bladder cancer research has found novel insights into its metabolic behavior, providing excellent start-points for new diagnostic and therapeutic strategies. Metabolomics data analysis can lead to the discovery of a “signature pathway” associated with the progression of bladder cancer; this aspect could be potentially valuable in predictions of clinical outcomes and the introduction of new treatments. However, further studies are needed to give stronger evidence and to make these tools feasible for use in clinical practice.
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Affiliation(s)
- Nicola Antonio di Meo
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, Italy; (N.A.d.M.); (D.L.); (M.R.); (M.B.); (P.D.)
| | - Davide Loizzo
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, Italy; (N.A.d.M.); (D.L.); (M.R.); (M.B.); (P.D.)
- Division of Urology, Virginia Commonwealth University (VCU) Health, Richmond, VA 23298, USA; (S.D.P.); (R.A.)
| | - Savio Domenico Pandolfo
- Division of Urology, Virginia Commonwealth University (VCU) Health, Richmond, VA 23298, USA; (S.D.P.); (R.A.)
- Division of Urology, University of Naples “Federico II”, 80100 Naples, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University (VCU) Health, Richmond, VA 23298, USA; (S.D.P.); (R.A.)
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy;
| | - Camillo Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy; (C.P.); (A.S.)
| | - Alessandro Stella
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70124 Bari, Italy; (C.P.); (A.S.)
| | - Cinzia Bizzoca
- Department of General Surgery “Ospedaliera”, Polyclinic Hospital of Bari, 70124 Bari, Italy; (C.B.); (L.V.)
| | - Leonardo Vincenti
- Department of General Surgery “Ospedaliera”, Polyclinic Hospital of Bari, 70124 Bari, Italy; (C.B.); (L.V.)
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Octavian Sabin Tataru
- I.O.S.U.D., George Emil Palade University of Medicine and Pharmacy, Science and Technology, 540142 Targu Mures, Romania;
| | - Monica Rutigliano
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, Italy; (N.A.d.M.); (D.L.); (M.R.); (M.B.); (P.D.)
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, Italy; (N.A.d.M.); (D.L.); (M.R.); (M.B.); (P.D.)
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, Italy; (N.A.d.M.); (D.L.); (M.R.); (M.B.); (P.D.)
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, Italy; (N.A.d.M.); (D.L.); (M.R.); (M.B.); (P.D.)
- Correspondence:
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Modified Glasgow Prognostic Score as a Predictor of Recurrence in Patients with High Grade Non-Muscle Invasive Bladder Cancer Undergoing Intravesical Bacillus Calmette–Guerin Immunotherapy. Diagnostics (Basel) 2022; 12:diagnostics12030586. [PMID: 35328139 PMCID: PMC8947693 DOI: 10.3390/diagnostics12030586] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 01/09/2023] Open
Abstract
Background: A systemic inflammatory marker, the modified Glasgow prognostic score (mGPS), could predict outcomes in non-muscle-invasive bladder cancer (NIMBC). We aimed to investigate the predictive power of mGPS in oncological outcomes in HG/G3 T1 NMIBC patients undergoing Bacillus Calmette–Guérin (BCG) therapy. Methods: We retrospectively reviewed patient’s medical data from multicenter institutions. A total of 1382 patients with HG/G3 T1 NMIBC have been administered adjuvant intravesical BCG therapy, every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months. The analysis of mGPS for recurrence and progression was performed using multivariable and univariable Cox regression models. Results: During follow-up, 659 patients (47.68%) suffered recurrence, 441 (31.91%) suffered progression, 156 (11.28%) died of all causes, and 67 (4.84%) died of bladder cancer. At multivariable analysis, neutrophil to lymphocyte ratio [hazard ratio (HR): 7.471; p = 0.0001] and erythrocyte sedimentation rate (ESR) (HR: 0.706; p = 0.006 were significantly associated with recurrence. mGPS has no statistical significance for progression (p = 0.076). Kaplan–Meier survival analysis showed a significant difference in survival among patients from different mGPS subgroups. Five-year OS was 93% (CI 95% 92–94), in patients with mGPS 0, 82.2% (CI 95% 78.9–85.5) in patients with mGPS 1 and 78.1% (CI 95% 60.4–70) in mGPS 2 patients. Five-year CSS was 98% (CI 95% 97–99) in patients with mGPS 0, 90% (CI 95% 87–94) in patients with mGPS 1, and 100% in mGPS 2 patients. Limitations are applicable to a retrospective study. Conclusions: mGPS may have the potential to predict recurrence in HG/G3 T1 NMIBC patients, but more prospective, with large cohorts, studies are needed to study the influence of systemic inflammatory markers in prediction of outcomes in NMIBC for a definitive conclusion.
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Stokke K, Sandvei MS, Grønberg BH, Slaaen M, Killingberg KT, Halvorsen TO. Prognostic Value of Post First-Line Chemotherapy Glasgow Prognostic Score in Advanced Non-Small Cell Lung Cancer. CLINICAL MEDICINE INSIGHTS: ONCOLOGY 2022; 16:11795549221086578. [PMID: 35342321 PMCID: PMC8943446 DOI: 10.1177/11795549221086578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/21/2021] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The Glasgow prognostic score (GPS) is an established inflammatory prognostic index in cancer patients. Most studies have only measured GPS at baseline (B-GPS). Effective cancer therapy may reduce inflammation, and we investigated whether re-assessing GPS after first-line chemotherapy (E-GPS) provided more prognostic information than B-GPS in a phase III trial of advanced non-squamous non-small cell lung cancer (NSCLC). Methods: Glasgow prognostic score was assessed before and after carboplatin/vinorelbine chemotherapy. When assessing GPS, C-reactive protein (CRP) ⩾ 10 mg/L and albumin < 35 mg/L are defined as abnormal values. GPS 0: both values normal, GPS 1: one abnormal value, and GPS 2: both values abnormal. Results: Glasgow prognostic score at baseline and E-GPS were available in 138 patients. Median age was 67 years, 51% were women, and 94% had performance status 0-1. B-GPS was not a statistically significant prognostic factor (B-GPS 1 vs 0: hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 0.9-2.0; B-GPS 2 vs 0: HR = 1.46, 95% CI = 0.9-2.3), while E-GPS was (E-GPS 1 vs 0: HR = 1.57, 95% CI = 1.0-2.4; E-GPS 2 vs 0: HR = 2.77, 95% CI = 1.7-4.5). E-GPS was associated with treatment response ( P < .01), whereas B-GPS was not. Conclusion: Glasgow prognostic score at baseline after first-line chemotherapy provided more prognostic information than baseline GPS in patients with advanced non-squamous NSCLC and was associated with treatment response. ClinicalTrials.gov Identifier: NCT02004184.
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Affiliation(s)
- Kristin Stokke
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marie Søfteland Sandvei
- The Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bjørn Henning Grønberg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marit Slaaen
- Research Centre for Age-related Functional Decline and Disease (AFS), Innlandet Hospital Trust HF, Hamar, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin T Killingberg
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tarje O Halvorsen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Nagai T, Naiki T, Isobe T, Sugiyama Y, Etani T, Iida K, Nozaki S, Noda Y, Shimizu N, Tasaki Y, Mimura Y, Banno R, Kubota H, Hamamoto S, Kawai N, Yasui T. Modified Glasgow Prognostic Score 2 as a Prognostic Marker in Patients With Metastatic Urothelial Carcinoma. In Vivo 2021; 35:2793-2800. [PMID: 34410970 DOI: 10.21873/invivo.12565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND/AIM Predicting the prognosis of metastatic urothelial carcinoma (mUC) patients is needed for clinical decisions. We examined the value of a modified Glasgow prognostic score (mGPS) as a predictive marker for mUC patients. PATIENTS AND METHODS In a multicenter study, 68 mUC patients received short hydration gemcitabine/cisplatin (shGC) and 74 received pembrolizumab (PEM). Patients were allocated according to mGPS. Progression-free (PFS) and cancer-specific (CSS) survival were examined. RESULTS Higher mGPS reflected poorer PFS and CSS in shGC (p=0.03, p<0.0001, respectively) and PEM (p=0.02, p<0.001, respectively) patients. PFS for the high mGPS group was longer than that of the low mGPS group in the two cohorts (p <0.0001 for both), with similar CSS results (p<0.0001 and p<0.001, respectively). Multivariate analyses revealed high mGPS was a risk factor for poor CSS in both cohorts (HR=3.55, p<0.001, and HR=2.21, p<0.01, respectively). CONCLUSION In the mUC patients receiving shGC or PEM, mGPS was a predictive prognostic marker.
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Affiliation(s)
- Takashi Nagai
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Taku Naiki
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan;
| | - Teruki Isobe
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Yosuke Sugiyama
- Department of Pharmacy, Nagoya City University Hospital, Nagoya, Japan
| | - Toshiki Etani
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Keitaro Iida
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoshi Nozaki
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Yusuke Noda
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan.,Department of Urology, Toyota Kosei Hospital, Toyota, Japan
| | - Nobuhiko Shimizu
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshihiko Tasaki
- Department of Pharmacy, Nagoya City University Hospital, Nagoya, Japan
| | - Yoshihisa Mimura
- Department of Pharmacy, Nagoya City University Hospital, Nagoya, Japan
| | - Rika Banno
- Department of Urology, Konan Kosei Hospital, Konan, Japan
| | - Hiroki Kubota
- Department of Urology, Kainan Hospital, Yatomi, Japan
| | - Shuzo Hamamoto
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Noriyasu Kawai
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan
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11
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Schuettfort VM, Gust K, D'Andrea D, Quhal F, Mostafaei H, Laukhtina E, Mori K, Rink M, Abufaraj M, Karakiewicz PI, Luzzago S, Rouprêt M, Enikeev D, Zimmermann K, Deuker M, Moschini M, Sari Motlagh R, Grossmann NC, Katayama S, Pradere B, Shariat SF. Impact of the preoperative modified glasgow prognostic score on disease outcome after radical cystectomy for urothelial carcinoma of the bladder. Minerva Urol Nephrol 2021; 74:302-312. [PMID: 34114784 DOI: 10.23736/s2724-6051.21.04216-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To investigate the predictive and prognostic value of the preoperative modified Glasgow Prognostic Score (mGPS) in patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC). METHODS We conducted a retrospective analysis of an established multicenter database consisting of 4,335 patients who were treated with RC +/- adjuvant chemotherapy for UCB between 1979 and 2012. The mGPS of each patient was calculated on the basis of preoperative serum C-reactive protein and albumin. Uni- and multivariable logistic and Cox regression analyses were performed. The discriminatory ability of the models was assessed by calculating the area under receiver operating characteristics curves (AUC) and concordance-indices (C-Index). The additional clinical net-benefit was assessed using the decision curve analysis (DCA). RESULTS A mGPS of 0, 1, and 2 was observed in 3,158 (72.8%), 1,020 (23.5%), and 157 (3.6%) patients, respectively. On multivariable logistic regression analyses, mGPS of 1 or 2 were associated with an increased risk of pT3/4 disease at RC (OR 1.25, p=0.004 and OR 2.58, p<0.001, respectively) and/or lymph node metastasis (OR 1.7, p<0.001 and OR 3.9, p<0.001, respectively). Addition of the mGPS to a predictive model based on preoperatively available variables improved its accuracy for prediction of lymph node metastasis (change of AUC +3.7%, p<0.001). On multivariable Cox regression analyses, mGPS of 1 or 2 remained associated with worse recurrence-free survival (HR 1.14, p=0.03 and HR 1.89 p<0.001, respectively), cancer-specific survival (HR 1.16, p=0.032 and HR 2.1, p<0.001, respectively) and overall survival (HR 1.5, p=0.007 and HR 1.92 p<0.001, respectively) compared to mGPS of 0. The additional discriminatory ability of the mGPS for prognosis of survival outcomes in separate models that included either established pre- or postoperative variables did not improve the C-Index by a prognostically relevant degree (change of C-Index <2% for all models). On DCA, the inclusion of the mGPS did not meaningfully improve the net-benefit for clinical decision-making regarding survival outcomes. CONCLUSIONS We confirmed that an elevated mGPS is an independent risk factor for non-organ confined disease and poor survival outcomes in patients with UCB undergoing RC. However, the mGPS showed little value in improving the discriminatory ability of predictive and prognostic models that relied on either pre- or postoperative clinicopathological variables. The discriminatory ability of this biomarker in the age of immunotherapy warrants further evaluation.
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Affiliation(s)
- Victor M Schuettfort
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kilian Gust
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mohammad Abufaraj
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada
| | - Stefano Luzzago
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada.,Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Morgan Rouprêt
- GRC n°5, Predictive Onco-Urology, Ap-Hp, Urology, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Marina Deuker
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada.,Department of Urology, University Hospital Frankfurt, Frankfurt, Germany
| | - Marco Moschini
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland.,Department of Urology and Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Reza Sari Motlagh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nico C Grossmann
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Hospital Zurich, Zurich, Switzerland
| | - Satoshi Katayama
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Hospital of Tours, Tours, France
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria - .,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.,Department of Urology, University Hospital Frankfurt, Frankfurt, Germany.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,European Association of Urology Research Foundation, Arnhem, Netherlands
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12
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Rajendran G, Taylor JA, Woolbright BL. Natural products as a means of overcoming cisplatin chemoresistance in bladder cancer. CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2021; 4:69-84. [PMID: 35582013 PMCID: PMC9019192 DOI: 10.20517/cdr.2020.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022]
Abstract
Cisplatin remains an integral part of the treatment for muscle invasive bladder cancer. A large number of patients do not respond to cisplatin-based chemotherapy and efficacious salvage regimens are limited. Immunotherapy has offered a second line of treatment; however, only approximately 20% of patients respond, and molecular subtyping of tumors indicates there may be significant overlap in those patients that respond to cisplatin and those patients that respond to immunotherapy. As such, restoring sensitivity to cisplatin remains a major hurdle to improving patient care. One potential source of compounds for enhancing cisplatin is naturally derived bioactive products such as phytochemicals, flavonoids and others. These compounds can activate a diverse array of different pathways, many of which can directly promote or inhibit cisplatin sensitivity. The purpose of this review is to understand current drug development in the area of natural products and to assess how these compounds may enhance cisplatin treatment in bladder cancer patients.
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Affiliation(s)
- Ganeshkumar Rajendran
- Department of Urology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - John A Taylor
- Department of Urology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Benjamin L Woolbright
- Department of Urology, University of Kansas Medical Center, Kansas City, KS 66160, USA
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13
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Brown JT, Liu Y, Shabto JM, Martini DJ, Ravindranathan D, Hitron EE, Russler GA, Caulfield S, Yantorni LB, Joshi SS, Kissick H, Ogan K, Harris WB, Carthon BC, Kucuk O, Master VA, Bilen MA. Baseline Modified Glasgow Prognostic Score Associated with Survival in Metastatic Urothelial Carcinoma Treated with Immune Checkpoint Inhibitors. Oncologist 2021; 26:397-405. [PMID: 33634507 DOI: 10.1002/onco.13727] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The modified Glasgow prognostic score (mGPS), a clinical tool that incorporates albumin and C-reactive protein, has proven useful in the prognostication of multiple cancers. Several immune checkpoint inhibitors (ICIs) have been approved for the treatment of metastatic urothelial cell carcinoma (mUC), but a prognostic biomarker is needed. We investigated the impact of mGPS on survival outcomes in patients with mUC receiving ICIs. MATERIALS AND METHODS We retrospectively reviewed patients with mUC treated with ICIs (programmed cell death protein 1 or programmed cell death ligand 1 inhibitors) at Winship Cancer Institute from 2015 to 2018. Overall survival (OS) and progression-free survival (PFS) were measured from the start date of ICI until death or clinical or radiographic progression, respectively. mGPS was defined as a summary score with one point given for C-reactive protein >10 mg/L and/or albumin <3.5 g/dL. Univariate (UVA) and multivariate (MVA) analyses were carried out using Cox proportional hazard model. These outcomes were also assessed by Kaplan-Meier analysis. RESULTS A total of 53 patients were included with a median follow-up 27.1 months. The median age was 70 years, with 84.9% male and 20.8% Black. Baseline mGPS was 0 in 43.4%, 1 in 28.3% and 2 in 28.3%. Increased mGPS at the time of ICI initiation was associated with poorer OS and PFS in UVA, MVA, and Kaplan-Meier analyses. CONCLUSION The mGPS may be a useful prognostic tool in patients with mUC when treatment with ICI is under consideration. These results warrant a larger study for validation. IMPLICATIONS FOR PRACTICE The ideal prognostic tool for use in a busy clinical practice is easy-to-use, cost-effective, and capable of accurately predicting clinical outcomes. There is currently no universally accepted risk score in metastatic urothelial cell carcinoma (mUC), particularly in the immunotherapy era. The modified Glasgow prognostic score (mGPS) incorporates albumin and C-reactive protein and may reflect underlying chronic inflammation, a known risk factor for resistance to immune checkpoint inhibitors (ICIs). This study found that baseline mGPS is associated with survival outcomes in patients with mUC treated with ICIs and may help clinicians to prognosticate for their patients beginning immunotherapy.
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Affiliation(s)
- Jacqueline T Brown
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Yuan Liu
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.,Departments of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Julie M Shabto
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Dylan J Martini
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Deepak Ravindranathan
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Emilie Elise Hitron
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Greta Anne Russler
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Sarah Caulfield
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Lauren Beth Yantorni
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Shreyas S Joshi
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Haydn Kissick
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Kenneth Ogan
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Wayne B Harris
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Bradley C Carthon
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Omer Kucuk
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Viraj A Master
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Mehmet Asim Bilen
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA.,Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
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14
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Ferro M, Di Mauro M, Cimino S, Morgia G, Lucarelli G, Abu Farhan AR, Vartolomei MD, Porreca A, Cantiello F, Damiano R, Busetto GM, Del Giudice F, Hurle R, Perdonà S, Borghesi M, Bove P, Autorino R, Crisan N, Marchioni M, Schips L, Soria F, Mari A, Minervini A, Veccia A, Battaglia M, Terracciano D, Musi G, Cordima G, Muto M, Mirone V, de Cobelli O, Russo GI. Systemic combining inflammatory score (SCIS): a new score for prediction of oncologic outcomes in patients with high-risk non-muscle-invasive urothelial bladder cancer. Transl Androl Urol 2021; 10:626-635. [PMID: 33718065 PMCID: PMC7947442 DOI: 10.21037/tau-20-1272] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background An accurate and early diagnosis of bladder cancer (BC) is essential to offer patients the most appropriate treatment and the highest cure rate. For this reason, patients need to be best stratified by class and risk factors. We aimed to develop a score able to better predict cancer outcomes, using serum variables of inflammation. Methods A total of 1,510 high-risk non-muscle invasive bladder cancer (NMIBC) patients were included in this retrospective observational study. Patients with pathologically proven T1 HG/G3 at first TURBT were included. Systemic combined inflammatory score (SCIS) was calculated according to systemic inflammatory markers (SIM), modified Glasgow prognostic score (mGPS), and prognostic nutritional index (PNI) dichotomized (final score from 0 to 3). Results After 48 months of follow-up (IQR 40.0-73.0), 727 patients recurred (48.1%), 485 progressed (32.1%), 81 died for cancer (7.0%), and 163 died for overall causes (10.8%). Overall, 231 (15.3%) patients had concomitant Cis, 669 (44.3%) patients had multifocal pathology, 967 (64.1%) patients had tumor size >3 cm. Overall, 357 (23.6%) patients received immediate-intravesical therapy, 1,356 (89.8%) received adjuvant intravesical therapy, of which 1,382 (91.5%) received BCG, 266 (17.6%) patients received mitomycin C, 4 (0.5%) patients received others intravesical therapy. Higher SCIS was independently predictive of recurrence (hazard ratio HR 1.5, 1.3 and 2.2) and cancer specific mortality for SCIS 0 and 3 (HR: 1.61 and 2.3), and overall mortality for SCIS 0 and 3 (HR: 2.4 and 3.2). Conversely, SCIS was not associated with a higher probability of progression. Conclusions The inclusion of the SCIS in clinical practice is simple to apply and can help improve the prediction of cancer outcomes. It can identify patients with high-grade BC who are more likely to experience disease mortality.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Marina Di Mauro
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | - Sebastiano Cimino
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | - Giuseppe Morgia
- Urology Section, Department of Surgery, University of Catania, Catania, Italy.,Urology Section, Istituto Oncologico Del Mediterraneo (IOM), Viagrande, Italy
| | - Giuseppe Lucarelli
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Abdal Rahman Abu Farhan
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania
| | - Mihai Dorin Vartolomei
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania
| | - Angelo Porreca
- Department of Urology, Abano Terme Hospital, Padua, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | | | - Rodolfo Hurle
- Department of Urology, Istituto Clinico Humanitas Istituto di Ricovero e Cura a Carattere Scientifico-Clinical and Research Hospital, Milan, Italy
| | - Sisto Perdonà
- Uro-Gynecological Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale" IRCCS, Naples, Italy
| | - Marco Borghesi
- Department of Urology, University of Bologna, Bologna, Italy
| | - Pierluigi Bove
- Division of Urology, Department of Experimental Medicine and Surgery, Urology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Nicolae Crisan
- Department of Urology, University of Medicine and Pharmacy of Cluj-Napoca, Cluj-Napoca, Romania
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, Urology Unit, Chieti, Italy
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Sciences, "SS. Annunziata" Hospital, Urology Unit, Chieti, Italy
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Minervini
- Department of Urology, University of Florence, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Alessandro Veccia
- Division of Urology, Department of Experimental Medicine and Surgery, Urology Unit, Tor Vergata University of Rome, Rome, Italy.,Urology Unit, Department of Medical and Surgical Specialties, Radiological Science, and Public Health, ASST Ospedali Civili, University of Brescia, Brescia, Italy
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gennaro Musi
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Giovanni Cordima
- Division of Urology, European Institute of Oncology, Milan, Italy
| | - Matteo Muto
- Radiotherapy Unit, "S.G. Moscati" Hospital, Avellino, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy
| | | | - Giorgio Ivan Russo
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
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15
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Mei Y, Zheng J, Xiang P, Liu C, Fan Y. Prognostic value of the miR-200 family in bladder cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22891. [PMID: 33217797 PMCID: PMC7676564 DOI: 10.1097/md.0000000000022891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND We aimed to evaluate the prognostic significance of high expression of the miR-200 family of microRNAs in bladder cancer. METHODS Studies on the correlation between the miR-200 family and prognosis in patients with bladder cancer were searched in databases. Combined hazard ratios (HRs) were calculated based on HRs and 95% confidence intervals (CIs) for overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). Cochranes Q test and the I statistic were utilized to assess heterogeneity across the included studies. Potential publication bias was analyzed by Begg and Egger tests. The meta-analysis was conducted using RevMan 5.3 and Stata SE12.0. RESULTS Data from a total of 1150 patients from 8 studies were extracted. The meta-analysis revealed that high expression of the miR-200 family was correlated with better OS (pooled hazard ratio: 0.50, 95% confidence interval: 0.40-0.62), CSS (pooled hazard ratio: 0.36, 95% confidence interval: 0.22-0.59) and RFS (pooled hazard ratio: 0.48, 95% confidence interval: 0.36-0.65). Both Begg test and Egger test verified no publication bias within the included cohorts. CONCLUSION The high expression of the miR-200 family is strongly associated with better prognosis in bladder cancer patients, which will improve bladder cancer management in clinical practice.
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Affiliation(s)
- Yanhui Mei
- Department of Urology, Qilu Hospital of Shandong University, Jinan
- Department of Urology, Binzhou Medical University Hospital, Binzhou
| | - Jianbo Zheng
- Department of Urology, Zibo Central Hospital, Zibo, Shandong
| | - Ping Xiang
- Department of Urology, Anhui Provincial Hospital, Hefei, Anhui
| | - Cheng Liu
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Yidong Fan
- Department of Urology, Qilu Hospital of Shandong University, Jinan
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16
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Ou N, Song Y, Liu M, Zhu J, Yang Y, Liu X. Development and Validation of a Nomogram to Predict Lymph Node Metastasis in Patients With T1 High-Grade Urothelial Carcinoma of the Bladder. Front Oncol 2020; 10:532924. [PMID: 33123462 PMCID: PMC7566179 DOI: 10.3389/fonc.2020.532924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose This study aims to develop and validate a nomogram to predict lymph node (LN) metastasis preoperatively in patients with T1 high-grade urothelial carcinoma. Methods We retrospectively evaluated the data of 2,689 patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC) and bilateral lymphadenectomy in two medical centers. Eventually, 412 patients with T1 high-grade urothelial carcinoma were enrolled in the primary cohort to develop a prognostic nomogram designed to predict LN status. An independent validation cohort (containing 783 consecutive patients during the same period) was subjected to validate the predicting model. Binary regression analysis was used to develop the predicting nomogram. We assessed the performance of the nomogram concerning its clinical usefulness, calibration, and discrimination. Results Overall, 69 (16.75%), and 135 (17.24%) patients had LN metastasis in the primary cohort and external validation cohort, respectively. The final nomogram included information on tumor number, tumor size, lymphovascular invasion (LVI), fibrinogen, and monocyte-to-lymphocyte ratio (MLR). The nomogram showed good predictive accuracy and calibration with a concordance index in the primary cohort of 0.853. The application of the nomogram in the external validation cohort still gave good discrimination (C-index, 0.845) and good calibration. The analysis of the decision curve shows that the nomogram has clinical application value. Conclusion The nomogram that incorporated the tumor number, tumor size, LVI, fibrinogen, and MLR showed favorable predictive accuracy for LN metastasis. It may be conveniently used to predict LN metastasis in patients with T1 high-grade urothelial carcinoma and be helpful in guiding treatment decisions.
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Affiliation(s)
- Ningjing Ou
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuxuan Song
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mohan Liu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, China
| | - Jun Zhu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yongjiao Yang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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17
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Kang X, Shi H, Wang D, Xiao Z, Tian J, Bi X, Jiang W, Li C, Ma J, Zheng S, Sun Y, Shou J. Combination of Hematology Indicators and Oncological Characteristics as a New Promising Prognostic Factor in Localized Clear Cell Renal Cell Carcinoma. Cancer Manag Res 2020; 12:10023-10033. [PMID: 33116859 PMCID: PMC7567576 DOI: 10.2147/cmar.s264400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose This study aimed to construct a predictive model for recurrence and metastasis in patients with localized clear cell renal cell carcinoma (ccRCC) based on multiple preoperative blood indexes and oncological characteristics. Patients and Methods Overall, 442 patients with localized ccRCC between 2013 and 2015 were included. Using least absolute shrinkage and selection operator (LASSO) Cox regression analysis, the top three risk factors from the peripheral blood indicators were screened to construct a risk score, and a prognostic model was established. Harrell's concordance index (C-index) was applied to evaluate the predictive accuracy of the model for predicting disease-free survival (DFS) in ccRCC. Results Out of 38 blood indexes, the top three predictors were fibrinogen (FIB), C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR). The FIB-CRP-NLR (FCN) score (hazard ratio [HR]: 1.86, 95% confidence interval [CI]: 1.21-2.9, P = 0.005) was an independent prognostic factor in multivariate analysis. Furthermore, the FIB-CRP-NLR-T-Grade (FCNTG) risk model combining FCN score, T stage and Furhman grade achieved a higher prognostic accuracy (mean C-index, 0.728) than both the FCN score alone (mean C-index, 0.675) and the stage, size, grade, and necrosis (SSIGN) score (mean C-index, 0.686) in the validation cohort. Conclusion The FCN score combining peripheral blood indicators of inflammation and coagulation is an independent prognostic marker of ccRCC. The FCNTG model, which systemically incorporates preoperative blood indexes to oncological characteristics, shows its advantages of convenience and high prediction efficiency.
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Affiliation(s)
- Xiangpeng Kang
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Hongzhe Shi
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Dong Wang
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Zejun Xiao
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Jun Tian
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Xingang Bi
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Weixing Jiang
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Changling Li
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Jianhui Ma
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Shan Zheng
- Department of Pathology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
| | - Yueping Sun
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, People's Republic of China
| | - Jianzhong Shou
- Department of Urinary Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, People's Republic of China
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18
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Mari A, Muto G, Di Maida F, Tellini R, Bossa R, Bisegna C, Campi R, Cocci A, Viola L, Grosso A, Scelzi S, Lapini A, Carini M, Minervini A. Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer. Arab J Urol 2020; 19:2-8. [PMID: 33763243 PMCID: PMC7954471 DOI: 10.1080/2090598x.2020.1814974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective To evaluate the impact of preoperative markers of systemic inflammation on complications and oncological outcomes in patients aged ≥75 years treated with radical cystectomy (RC) for urothelial bladder cancer (UBC). Patients and methods The clinical data of 694 patients treated with open RC for UBC at our institution between January 2008 and December 2015 were retrospectively reviewed. Patients aged <75 years, with distant metastases, other-than-urothelial histological type, comorbidities that could affect the systemic inflammatory markers, and patients who received neoadjuvant chemotherapy were excluded. Multivariable regression models were built for the prediction of major postoperative surgical complications, disease recurrence, cancer-specific mortality (CSM), and overall mortality (OM). Results The median (interquartile range [IQR]) age at surgery was 79 (75–83) years. Major postoperative surgical complications were registered in 41.9% of the patients. The 5-year overall survival, cancer-specific survival and recurrence-free survival rates were 42.4% (95% confidence interval [CI] 34.7–49.9%), 70.3% (95% CI 62.3–76.9%), and 59.8% (95% CI 52.4–66.5), respectively. At multivariable analysis, higher levels of fibrinogen and a modified Glasgow Prognostic Score (mGPS) of 1 and 2 at baseline were independently associated with higher risk of major postoperative complications and of CSM. The inclusion of mGPS and fibrinogen to a standard multivariable model for recurrence and for CSM increased discrimination from 69.4% to 73.0% and from 71.3% to 73.9%, respectively. Preoperative neutrophil-to-lymphocyte ratio of >3 was independently associated with OM (hazard ratio 1.38, 95% CI 1.01–1.77; P = 0.01). Conclusions In a cohort of elderly patients with UBC treated with RC, fibrinogen and mGPS appeared to be the most relevant prognostic measurements and increased the accuracy of clinicopathological preoperative models to predict major postoperative complications, disease recurrence and mortality. Abbreviations ASA: American Society of Anesthesiologists; CCI: Charlson Comorbidity Index; CIS: carcinoma in situ; CRP: C-reactive protein; CSM: cancer-specific mortality; CSS: cancer-specific survival; ECOG PS: Eastern Cooperative Oncology Group Performance Status; HDL: high-density lipoprotein; (S)HR: (subdistribution) hazard ratio; LND: lymphadenectomy; LVI: lymphovascular invasion; mGPS: modified Glasgow Prognostic Score; NLR: neutrophil-to-lymphocyte ratio; NOC: non-organ-confined; OM: overall mortality; OR: odds ratio; OS: overall survival; RC: radical cystectomy; RNU: radical nephroureterectomy; UBC: urothelial bladder cancer; UTUC: upper urinary tract urothelial carcinoma
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Affiliation(s)
- Andrea Mari
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Gianluca Muto
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Fabrizio Di Maida
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Riccardo Tellini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Riccardo Bossa
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Claudio Bisegna
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Riccardo Campi
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Cocci
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lorenzo Viola
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Antonio Grosso
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Sabino Scelzi
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alberto Lapini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Marco Carini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andrea Minervini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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19
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Yuk HD, Ku JH. Role of Systemic Inflammatory Response Markers in Urothelial Carcinoma. Front Oncol 2020; 10:1473. [PMID: 32974174 PMCID: PMC7471310 DOI: 10.3389/fonc.2020.01473] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/10/2020] [Indexed: 12/19/2022] Open
Abstract
Urothelial carcinoma (UC) can occur in various parts of the urinary tract and occurs in different stages and grades. The disease recurs frequently and is monitored through a series of invasive tests, such as cystoscopy or ureteroscopy, over the lifetime of an individual. Although many researchers have attempted to stratify the risks of UC, with the majority being based on cancer characteristics and host factors such as performance status, a risk classification system has yet to be fully developed. Cancer affects various parts of the body through the systemic immune response, including changes in hormones, the number and ratio of white blood cells and platelets, and C-reactive protein (CRP) or albumin levels under the influence of neuroendocrine metabolism, hematopoietic function, and protein and energy metabolism, respectively. Herein, we reviewed various systemic inflammatory response markers (SIRs) related to UC, including CRP, albumin-globulin ratio, albumin, Glasgow prognostic score (GPS), modified GPS, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio. Our aim was to summarize the role of various SIRs in the treatment of patients with UC.
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Affiliation(s)
- Hyeong Dong Yuk
- Department of Urology, Seoul National University Hospital, Seoul, South Korea.,College of Medicine, Seoul National University, Seoul, South Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul, South Korea.,College of Medicine, Seoul National University, Seoul, South Korea
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20
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Zhang L, Li L, Liu J, Wang J, Fan Y, Dong B, Zhu Z, Zhang X. Meta-analysis of multiple hematological biomarkers as prognostic predictors of survival in bladder cancer. Medicine (Baltimore) 2020; 99:e20920. [PMID: 32791672 PMCID: PMC7387011 DOI: 10.1097/md.0000000000020920] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Accumulating emerging studies have demonstrated that systemic inflammation can obviously affect tumor occurrence and progression. Nevertheless, the prognostic value of hematological inflammation biomarkers in bladder cancer is controversial. Thus, we conducted a meta-analysis to evaluate the key hematological biomarkers with various clinical outcomes in bladder cancer. METHODS We used online databases PUBMED and EMBASE to search relevant studies published prior to August 2019. After collecting the basic characteristics and prognostic data from the studies included, overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) were used as primary results. Subgroup analyses were performed according to ethnicity, the number of samples, survival outcomes, the value of cut-off, follow-up time and metastasis stage. RESULTS Thirty-three independent studies with 17,087 bladder cancer patients were added in the present analysis. The collected results showed that the increased neutrophil-to-lymphocyte ratio was associated with a poor OS (hazard ratio [HR] = 1.48, 95% confidence interval [CI]: 1.32-1.67, P < .00001), CSS (HR = 1.71, 95%CI: 1.35-2.18, P < .0001) and PFS (HR = 1.59, 95%CI: 1.38-1.83, P < .00001). Additionally, the elevated platelet-to-lymphocyte ratio was related to a poor OS (HR = 1.29, 95% CI: 1.07-1.54, P = .007), CSS (HR = 1.14, 95%CI = 0.98-1.34, P = .02) and PFS (HR = 1.2, 95%CI: 1.08-1.34, P = .0008). Moreover, a decreased lymphocyte-to-monocyte ratio was associated with a poor OS (HR = 0.77, 95% CI: 0.70-0.84, P = .001), CSS (HR = 0.76, 95%CI: 0.70-0.84). An elevated modified Glasgow prognostic score was also associated with a poor OS (HR = 2.71, 95%CI: 1.08-2.82, P = .003), CSS (HR = 1.50, 95%CI: 0.56-4.05) and PFS (HR = 1.52, 95%CI: 1.23-1.88, P = .001). CONCLUSIONS Our study indicated that the pretreatment hematological biomarkers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and modified Glasgow prognostic score) were predicative biomarkers of prognosis in bladder cancer patients. Further research is needed to conduct further prospective and multicenter studies to confirm our findings.
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Affiliation(s)
| | - Longqing Li
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
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21
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Kikuchi K, Nakamura R, Segawa T, Oikawa H, Ariga H. Modified Glasgow prognostic score can predict survival of muscle invasive bladder cancer patients after radiotherapy. JOURNAL OF RADIATION RESEARCH 2020; 61:616-621. [PMID: 32567660 PMCID: PMC7336815 DOI: 10.1093/jrr/rraa039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/07/2020] [Indexed: 06/11/2023]
Abstract
In patients with various cancers, modified Glasgow prognostic score (mGPS) before treatment has predicted prognoses after antitumor therapy. This study aimed to assess whether pretreatment mGPS also has predictive value in patients with muscle-invasive bladder cancer (MIBC) after radiotherapy. A retrospective review accumulated 98 consecutive MIBC patients treated with definitive 3D-conformal radiotherapy from January 2011 to December 2016 in a single center. It included cT2-4bN0-3M0 patients with a median age of 79 years (range: 49 to 95 years). Radiotherapy was delivered at 60-66 Gy for bladder cancer. Patients were categorized in terms of their pretreatment serum albumin and C-reactive protein (CRP) values as mGPS_0, mGPS_1, and mGPS_2. Among them, cumulative overall survival (OS) rates were compared by Kaplan-Meier plots with log-rank tests. The number of patients with mGPS_0, mGPS_1, and mGPS_2 were 40, 40, and 18, respectively. The median follow-up time for all patients was 19 months (range: 2-73 months). The 2-year OS rate for all patients was 75.7%. The 2-year OS rates for mGPS_0, mGPS_1, and mGPS_2 were 85.1%, 71.3%, and 60.9%, respectively. Kaplan-Meier curves revealed a significantly higher cumulative OS rate for mGPS_0 compared with mGPS_1 and mGPS_2 (P = 0.003). Using multivariate Cox regression analysis, mGPS_0 and good performance status were associated with favorable OS rates, of which mGPS_0 was more significant (Hazard ratio 2.74, 95% CI 1.30-5.57, P = 0.008). Modified Glasgow prognostic score may be a novel biomarker that can predict survival in patients with MIBC after radiotherapy.
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Affiliation(s)
- Koyo Kikuchi
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Ryuji Nakamura
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Takafumi Segawa
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Hirobumi Oikawa
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
| | - Hisanori Ariga
- Department of Radiation Oncology, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3695, Japan
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22
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Wang Z, He Y, Wang N, Zhang T, Wu H, Jiang X, Mo L. Clinical value of texture analysis in differentiation of urothelial carcinoma based on multiphase computed tomography images. Medicine (Baltimore) 2020; 99:e20093. [PMID: 32358396 PMCID: PMC7440185 DOI: 10.1097/md.0000000000020093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Identification of histologic grading of urothelial carcinoma still depends on histopathologic examination. As an emerging and promising imaging technology, radiomic texture analysis is a noninvasive technique and has been studied to differentiate various tumors. This study explored the value of computed tomography (CT) texture analysis for the differentiation of low-grade urothelial carcinoma (LGUC), high-grade urothelial carcinoma (HGUC), and their invasive properties.Radiologic data were analyzed retrospectively for 94 patients with pathologically proven urothelial carcinomas from November 2016 to April 2019. Pathologic examination demonstrated that tumors were: high grade in 43 cases, and low grade in 51 cases; and nonmuscle invasive (NMI) in 37 cases, and muscle invasive (MI) in 37 cases. Maximum tumor diameters on CT scan were manually outlined as regions of interest and 78 texture features were extracted automatically. Three-phasic CT images were used to measure texture parameters, which were compared with postoperative pathologic grading and invasive results. The independent sample t test or Mann-Whitney U test was used to compare differences in parameters. Receiver-operating characteristic curves for statistically significant parameters were used to confirm efficacy.Of the 78 features extracted from each phase of CT images, 26 (33%), 20 (26%), and 22 (28%) texture parameters were significant (P < .05) for differentiating LGUC from HGUC, while 19 (24%), 16 (21%), and 30 (38%) were significant (P < .05) for differentiating NMI from MI urothelial carcinoma. Highest areas the under curve for differentiating grading and invasive properties were obtained by variance (0.761, P < .001) and correlation (0.798, P < .001) on venous-phase CT images.Texture analysis has the potential to distinguish LGUC and HGUC, or NMI from MI urothelial carcinoma, before surgery.
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Affiliation(s)
- Zihua Wang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yufang He
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
| | - Nianhua Wang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
| | - Ting Zhang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
| | - Hongzhen Wu
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
| | - Xinqing Jiang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lei Mo
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
- Department of Radiology, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
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23
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The prevalence of cancer associated systemic inflammation: Implications of prognostic studies using the Glasgow Prognostic Score. Crit Rev Oncol Hematol 2020; 150:102962. [PMID: 32344318 DOI: 10.1016/j.critrevonc.2020.102962] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 02/07/2023] Open
Abstract
The prognostic importance of SIR in patients with cancer is widely recognised. More recently it has become clear that the systemic inflammatory response is an important etiologic factor in the development of cancer cachexia. Two recent meta-analysis carried out in 2017 and 2018 were interrogated and the number of patients with specific cancer types were identified. The percentage of patients with operable cancer (n>28,000) who were systemically inflamed varied from 21% to 38%. The percentage of patients with inoperable cancer (n>12,000) who were systemically inflamed varied from 29% to 79%. Overall, the percentage of patients (n>40,000) who were systemically inflamed varied from 28% to 63% according to tumour type. The most commonly studied cancer was colorectal cancer (n∼10,000 patients) and 40% were systemically inflamed.
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24
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Cho JM, Moon KT, Lee HJ, Shin SC, Choi JD, Kang JY, Yoo TK. Nucleobindin 2 expression is an independent prognostic factor for bladder cancer. Medicine (Baltimore) 2020; 99:e19597. [PMID: 32221080 PMCID: PMC7220399 DOI: 10.1097/md.0000000000019597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Nucleobindin 2 (NUCB2) has been reported to play an important role in both tumorigenesis and cancer progression. This study aimed to examine the clinical significance of NUCB2 expression urothelial carcinoma of the bladder (UCB).The expression level of NUCB2 and its correlation with clinicopathological parameters was analyzed in 225 UCB tissues by immunohistochemistry. Kaplan-Meier analysis and Cox proportional hazards regression models were used to investigate the correlation between NUCB2 expression and the prognosis of UCB patients. High NUCB2 expression of UCB patients significantly correlated with aggressive clinicopathological features. Patients with high NUCB2 had shorter overall survival and recurrence-free survival in Kaplan-Meier survival curve (P = .018 and P = .001, respectively).Our results show that high expression of NUCB2 associated with aggressive clinicopathological feature and predicted unfavorable prognosis in patients with UCB might serve as feasible biomarker for clinical outcome of UCB patients after surgery and potential therapeutic target in the future.
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Affiliation(s)
- Jeong Man Cho
- Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kyong Tae Moon
- Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Ho Jung Lee
- Department of Pathology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Soon Cheol Shin
- Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jae Duck Choi
- Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Jeong Yoon Kang
- Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Tag Keun Yoo
- Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea
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25
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Lyu Q, Lin A, Cao M, Xu A, Luo P, Zhang J. Alterations in TP53 Are a Potential Biomarker of Bladder Cancer Patients Who Benefit From Immune Checkpoint Inhibition. Cancer Control 2020; 27:1073274820976665. [PMID: 33356494 PMCID: PMC8480364 DOI: 10.1177/1073274820976665] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/16/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022] Open
Abstract
In recent years, immune checkpoint inhibitors (ICIs) targeting CTLA-4 or PD1/PDL1 have achieved remarkable success in the treatment of bladder cancer (BLCA), but only a few patients have shown durable clinical benefits. The prognostic role of a mutant form of the tumor suppressor gene TP53 (TP53-MT) in predicting the efficacy of ICIs is highly controversial; therefore, in this study, we obtained data for 210 patients from an immunotherapy cohort, 412 patients from The Cancer Genome Atlas (TCGA)-BLCA cohort and 18 BLCA cell lines from Genomics of Drug Sensitivity in Cancer (GDSC), and we performed integrated bioinformatic analysis to explore the relationships between TP53-MT and clinical benefits derived from ICI treatment and the underlying mechanisms. We conclude that TP53-MT is a potential indicator of a relatively good response to ICIs and associated with prolonged overall survival (OS) (log-rank test, hazard ratio (HR) = 0.65 [95% confidence interval (CI), 0.44-0.99], p = 0.041). Through integrated analysis with several platforms, we found that TP53-MT patients were more likely to benefit from ICIs than wild-type P53 (TP53-WT) patients, which may be the result of 2 major mechanisms. First, the patients with TP53-MT showed stronger tumor antigenicity and tumor antigen presentation, as indicated by a higher tumor mutational load, a higher neoantigen load and increased expression of MHC; second, the antitumor immunity preexisting in tumors was stronger in samples with TP53-MT than in those with TP53-WT, including enrichment of interferon-gamma, positive regulation of TNF secretion pathways and increased expression of some immunostimulatory molecules, such as CXCL9 and CXCL10. This study provided some clues for identifying patients who would potentially benefit from ICIs at the somatic genomic level, developing new indications for targeted second-generation sequencing and promoting the development of precision medicine.
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Affiliation(s)
- Qiong Lyu
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guang Zhou, China
| | - Anqi Lin
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guang Zhou, China
| | - Manming Cao
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guang Zhou, China
| | - Abai Xu
- Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guang Zhou, China
| | - Jian Zhang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guang Zhou, China
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26
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Shen Y, Lu Q, Ye H, Deng Z, Ma L, Zhang Q, Tang J, Yuan L. Genetic variant of MAML2 in the NOTCH signaling pathway and the risk of bladder cancer: A STROBE-compliant study. Medicine (Baltimore) 2020; 99:e18725. [PMID: 31914088 PMCID: PMC6959859 DOI: 10.1097/md.0000000000018725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The NOTCH signaling pathway plays a crucial role in cell phenotype and transformation. Single nucleotide polymorphisms (SNPs) may regulate gene expression to trigger bladder cancer susceptibility. Here, we aimed to explore the relationships between genetic variants in the NOTCH pathway and bladder cancer progression.We screened SNPs located in NOTCH pathway genes using the 1000 Genomes Project dataset (CHB). A case-control cohort study including 580 bladder cancer cases and 1101 controls was conducted to genotype the candidate SNPs. The expression quantitative trait locus (eQTL) and bioinformatics analyses were performed to explore the biological function of the SNPs' host gene and their relationship. Kaplan-Meier analysis was performed to assess the association between host gene expression and bladder cancer patient prognosis.The rs7944701 in the intron of mastermind-like 2 (MAML2) had the strongest signal and was related to bladder cancer risk (OR = 1.329, 95% CI = 1.115-1.583, P = .001). eQTL analysis showed that rs7944701 with a C allele was negatively associated with mastermind-like 2 (MAML2) expression (TT versus TC/CC). Bioinformatics analysis indicated that MAML2expression was lower in bladder cancer tissues than in non-tumor tissues (P = 5.46 × 10). Additionally, bladder cancer patients with high MAML2 expression had a significantly poorer prognosis (HR = 1.53, 95% CI = 1.29-1.82, P = .010).The rs7944701 in MAML2 was strongly associated with bladder cancer susceptibility in a Chinese population. This genetic variant and its host gene could be a potential novel biomarker for individuals suffering from bladder cancer.
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Affiliation(s)
- Yang Shen
- Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine
- Urological Tumor Department, Jiangsu Provincial Institute of Clinical Research
| | - Qian Lu
- Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine
- Urological Tumor Department, Jiangsu Provincial Institute of Clinical Research
| | - Hesong Ye
- Department of Urology, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Second Chinese Medicine Hospital, Nanjing, China
| | - Zhonglei Deng
- Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine
- Urological Tumor Department, Jiangsu Provincial Institute of Clinical Research
| | - Long Ma
- Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine
- Urological Tumor Department, Jiangsu Provincial Institute of Clinical Research
| | - Qingling Zhang
- Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine
- Urological Tumor Department, Jiangsu Provincial Institute of Clinical Research
| | - Jingyuan Tang
- Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine
- Urological Tumor Department, Jiangsu Provincial Institute of Clinical Research
| | - Lin Yuan
- Department of Urology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine
- Urological Tumor Department, Jiangsu Provincial Institute of Clinical Research
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Jin H, Lin T, Han P, Yao Y, Zheng D, Hao J, Hu Y, Zeng R. Efficacy of Raman spectroscopy in the diagnosis of bladder cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e18066. [PMID: 31764837 PMCID: PMC6882629 DOI: 10.1097/md.0000000000018066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Bladder cancer is one of the severest human malignancies which are hardly detected at an early stage. Raman spectroscopy is reported to maintain a high diagnostic accuracy, sensitivity and specificity in some tumors. METHODS We carried out a complete systematic review based on articles from PubMed/Medline, EMBASE, Web of Science, Ovid, Web of Knowledge, Cochrane Library and CNKI. We identified 2341 spectra with strict criteria in 9 individual studies between 2004 and 2018 in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We summarized the test performance using random effects models. RESULTS General pooled diagnostic sensitivity and specificity of RS to kidney cancer were 94% (95% CI 0.93-0.95) and 92% (95% CI 0.90-0.93). The pooled positive LR was 10.00 (95%CI 5.66-17.65) while the negative LR was 0.09 (95%CI 0.06-0.14). The pooled DOR was 139.53 (95% CI 54.60-356.58). The AUC of SROC was 0.9717. CONCLUSION Through this meta-analysis, we found a promisingly high sensitivity and specificity of RS in the diagnosis of suspected bladder masses and tumors. Other parameters like positive, negative LR, DOR, and AUC of the SROC curve all helped to illustrate the high efficacy of RS in bladder cancer diagnosis.
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Affiliation(s)
- Hongyu Jin
- Department of Liver Surgery, Liver Transplantation Center, West China Hospital
- West China School of Medicine
| | - Tianhai Lin
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Han
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | | | | | | | | | - Rui Zeng
- West China School of Medicine
- Department of Cardiovascular Diseases, West China Hospital, Sichuan University, Chengdu, China
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Qi F, Xu Y, Zheng Y, Li X, Gao Y. Pre-treatment Glasgow prognostic score and modified Glasgow prognostic score may be potential prognostic biomarkers in urological cancers: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:531. [PMID: 31807513 DOI: 10.21037/atm.2019.09.160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background The prognostic role of Glasgow prognostic score (GPS) or modified GPS (mGPS) in various cancers has been investigated. However, no unified conclusion could be drawn in urological cancers. So, we aimed to explore the potential role of GPS/mGPS in urological cancers. Methods Related studies were searched from PubMed, Web of Science and Embase up to May 30th, 2019 comprehensively. Their associations were assessed by the pooled hazard ratios (HRs) with its 95% confidence intervals (CIs). Results A total of 20 related studies were enrolled in this meta-analysis. The outcomes revealed that a relatively lower level of pre-treatment GPS/mGPS was associated with better overall survival (OS), cancer specific survival (CSS)/disease-specific survival (DSS) and disease-free survival (DFS)/progress-free survival (PFS)/recurrence-free survival (RFS) (pooled HR =2.70; 95% CI, 1.81-4.01; pooled HR =2.90; 95% CI, 2.00-4.22; pooled HR =2.43; 95% CI, 1.62-3.66, respectively). Subgroup analysis by cancer type for OS indicated that GPS/mGPS could also be a predictor no matter in renal cell cancer (RCC) or bladder cancer (BC) (pooled HR =3.60; 95% CI, 2.07-6.28 and pooled HR =2.71; 95% CI, 1.08-6.82). Similar results could be found in CSS/DSS (RCC: HR =4.12; 95% CI, 2.69-6.30) and in DFS/ PFS/RFS (RCC: HR =2.66; 95% CI, 1.82-3.90 and BC: HR =1.52; 95% CI, 1.23-1.88). As for the treatment subgroup, pre-treatment GPS/mGPS played an independent role in OS for patients no matter in which treatment type (Surgery: pooled HR =2.16; 95% CI, 1.43-3.26; Chemotherapy: pooled HR =4.41; 95% CI, 2.27-8.58); the same in CSS/DSS (Surgery: pooled HR =3.28; 95% CI, 1.73-6.20; Immunotherapy: pooled HR =2.72; 95% CI, 1.87-3.96) and DFS/RFS/PFS (Surgery: pooled HR =2.54; 95% CI, 1.65-3.92). Lastly, both GPS and mGPS played prognostic role in OS, CSS/DSS or DFE/RFS/PFS (OS: GPS: pooled HR =2.12; 95% CI, 1.04-4.32; mGPS: pooled HR =3.12; 95% CI, 1.87-5.20; CSS/DSS: GPS: pooled HR =2.87; 95% CI, 2.11-3.91; mGPS: pooled HR =3.00; 95% CI, 1.60-5.63; DFS/RFS/PFS: GPS: pooled HR =3.61; 95% CI, 1.43-9.07; mGPS: pooled HR =1.99; 95% CI, 1.32-2.99). Conclusions This study shed light on that GPS/mGPS might be an independent prognostic factor in urological cancers, indicating that a lower level of pre-treatment GPS/mGPS was closely related to better survival outcomes.
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Affiliation(s)
- Feng Qi
- Department of Urology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China.,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yunqiu Xu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yuxiao Zheng
- Department of Urology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Xiao Li
- Department of Urology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Yang Gao
- Department of Radiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China
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Yuk HD, Jeong CW, Kwak C, Kim HH, Moon KC, Ku JH. Clinical outcomes of muscle invasive bladder Cancer according to the BASQ classification. BMC Cancer 2019; 19:897. [PMID: 31500577 PMCID: PMC6734465 DOI: 10.1186/s12885-019-6042-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/15/2019] [Indexed: 12/31/2022] Open
Abstract
Background We evaluated the clinical efficacy and prognosis of muscle-invasive bladder cancer according to the basal/squamous-like (BASQ) classification system based on immunohistochemical staining [CK5/6(+), CK14(+), GATA3(−), and FOXA1(−)]. Methods One hundred patients diagnosed with muscle-invasive bladder cancer (cT2-4 N0-3 M0) were included in the study. All patients underwent radical cystectomy after transurethral removal of bladder tumor. Immunostaining was performed for CK5/6, CK14, FOXA1, and GATA3 antibodies on tissue microarray slides, and expression patterns were quantitatively analyzed using a scanning program. Results The median follow-up time was 77.4 (interquartile range: 39–120.9) months. The mean age of the patients was 65.1 ± 11.2 years. FOXA1 or CK14 expression greater than 1% was respectively positively and negatively correlated with overall survival (OS; p = 0.011 and p = 0.042, respectively), cancer-specific survival (CSS; p = 0.050 for both), and recurrence-free survival (RFS; p = 0.018 and p = 0.040, respectively). For CK5/6+ and GATA3- or FOXA1- expression, 10% CK5/6+ cells were negatively correlated with OS (p = 0.032 and p = 0.039, respectively) and with RFS in combination with FOXA1- only (p = 0.050). Conclusions In this study, CK14 expression was associated with a poor prognosis. The new classification system of bladder cancer based on molecular characteristics is expected to helpful tool for the establishment of personalized treatment strategies and associated prediction of therapeutic responses. Electronic supplementary material The online version of this article (10.1186/s12885-019-6042-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hyeong Dong Yuk
- Department of Urology, Inje University College of Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National Univervity College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National Univervity College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National Univervity College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyung Chul Moon
- Department of Pathology, Seoul National Univervity College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National Univervity College of Medicine, Seoul National University Hospital, Seoul, Korea.
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Zhang L, Wu B, Zha Z, Qu W, Zhao H, Yuan J. Clinicopathological factors in bladder cancer for cancer-specific survival outcomes following radical cystectomy: a systematic review and meta-analysis. BMC Cancer 2019; 19:716. [PMID: 31324162 PMCID: PMC6642549 DOI: 10.1186/s12885-019-5924-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 07/11/2019] [Indexed: 01/10/2023] Open
Abstract
Background Assessing the prognostic significance of specific clinicopathological features plays an important role in surgical management after radical cystectomy. This study investigated the association between ten clinicopathological characteristics and cancer-specific survival (CSS) in patients with bladder cancer. Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a literature search was conducted through the PubMed, EMBASE and Web of Science databases using appropriate search terms from the dates of inception until November 2018. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to evaluate the CSS. Fixed- or random-effects models were constructed according to existence of heterogeneity. Results Thirty-three articles met the eligibility criteria for this systematic review, which included 19,702 patients. The overall results revealed that CSS was associated with advanced age (old vs. young: pooled HR = 1.01; 95% CI:1.00–1.01; P < 0.001), higher tumor grade (3 vs. 1/2: pooled HR = 1.29; 95% CI:1.15–1.45; P < 0.001), higher pathological stage (3/4 vs. 1/2: pooled HR = 1.60; 95% CI:1.37–1.86; P < 0.001), lymph node metastasis (positive vs. negative: pooled HR = 1.51; 95% CI:1.37–1.67; P < 0.001), lymphovascular invasion (positive vs. negative: pooled HR = 1.36; 95% CI:1.28–1.45; P < 0.001), and soft tissue surgical margin (positive vs. negative: pooled HR = 1.42; 95% CI:1.30–1.56; P < 0.001). However, gender (male vs. female: pooled HR = 0.98; 95% CI: 0.96–1.01; P = 0.278), carcinoma in situ (positive vs. negative: pooled HR = 0.98; 95% CI: 0.88–1.10; P = 0.753), histology (transitional cell cancer vs variant: pooled HR = 0.90; 95% CI: 0.79–1.02; P = 0.089) and adjuvant chemotherapy (yes vs. no: pooled HR = 1.16; 95% CI: 1.00–1.34; P = 0.054) did not affect CSS after radical resection of bladder cancer. Conclusions Our results revealed that several clinicopathological characteristics can predict CSS risk after radical cystectomy. Prospective studies are needed to further confirm the predictive value of these variables for the prognosis of bladder cancer patients after radical cystectomy. Electronic supplementary material The online version of this article (10.1186/s12885-019-5924-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lijin Zhang
- Department of Urology, Affiliated Jiang-yin Hospital of the Southeast University Medical College, Jiang-yin, 214400, China.
| | - Bin Wu
- Department of Urology, Affiliated Jiang-yin Hospital of the Southeast University Medical College, Jiang-yin, 214400, China
| | - Zhenlei Zha
- Department of Urology, Affiliated Jiang-yin Hospital of the Southeast University Medical College, Jiang-yin, 214400, China
| | - Wei Qu
- Department of Pharmacy, Affiliated Jiang-yin Hospital of the Southeast University Medical College, Jiang-yin, 214400, China
| | - Hu Zhao
- Department of Urology, Affiliated Jiang-yin Hospital of the Southeast University Medical College, Jiang-yin, 214400, China
| | - Jun Yuan
- Department of Urology, Affiliated Jiang-yin Hospital of the Southeast University Medical College, Jiang-yin, 214400, China
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Suyama T, Kanbe S, Maegawa M, Shimizu H, Nakajima K. Prognostic significance of inflammation-based prognostic scoring in patients with upper urinary tract urothelial carcinoma. Int Braz J Urol 2019; 45:541-548. [PMID: 31038863 PMCID: PMC6786111 DOI: 10.1590/s1677-5538.ibju.2018.0251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 02/24/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate whether Glasgow Prognostic Score has prognostic significance in patients with upper urinary urothelial carcinoma. PATIENTS AND METHODS We retrospectively reviewed the clinical records of 74 patients with upper urinary urothelial carcinoma. We set the cut-off value for C-reactive protein as 1.0mg/dL, and 3.5mg/dL for albumin as Glasgow Prognostic Score. Their blood data including albumin and C-reactive protein for Glasgow Prognostic Score and cytokeratin 19 fragment 21-1 as a tumor marker were measured before starting treatment. The patients were stratified into three groups with Glasgow Prognostic Score: The Group-1, albumin ≥3.5g/dL and C-reactive protein < 1.0mg/dL; Group-2, albumin < 3.5g/dL or C-reactive protein ≥1.0mg/dL; Group-3, albumin < 3.5g/dL and C-reactive protein ≥1.0mg/dL. RESULTS The median follow-up for all patients was 26.9 months (range: 10.9-91.1 months), during which 37 (50%) patients died. There was a signifi cant difference in the estimated survival rate among the 3 groups stratified by Glasgow Prognostic Score. The estimated survival rate in the Group-1 was significantly higher than those in Groups 2 and 3. In the univariate analysis C-reactive protein, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were significant predictors of overall survival. On the multivariate analysis, serum cytokeratin 19 fragment 21-1 and Glasgow Prognostic Score were independently associated with shorter overall survival. CONCLUSION Our review suggests Glasgow Prognostic Score may play as a prognostic predictor for upper urinary urothelial carcinoma.
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Affiliation(s)
- Taisuke Suyama
- Department of Genitourinary, Sanaikai General Hospital (IMS), Japan
| | - Shigeki Kanbe
- Department of Genitourinary, Toho University Omori Medical Center, Japan
| | - Masanobu Maegawa
- Department of Genitourinary, Sanaikai General Hospital (IMS), Japan
| | - Hirofumi Shimizu
- Department of Genitourinary, Sanaikai General Hospital (IMS), Japan
| | - Koichi Nakajima
- Department of Genitourinary, Toho University Omori Medical Center, Japan
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Toward an Understanding of Patients’ and Their Partners’ Experiences of Bladder Cancer. Cancer Nurs 2019; 43:E254-E263. [DOI: 10.1097/ncc.0000000000000718] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Concomitant carcinoma in situ may not be a prognostic factor for patients with bladder cancer following radical cystectomy: a PRISMA-compliant systematic review and meta-analysis. World J Urol 2019; 38:129-142. [PMID: 30919100 DOI: 10.1007/s00345-019-02738-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/21/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Numerous recent studies have shown that concomitant carcinoma in situ (CIS) can be closely associated with the prognosis of patients with bladder cancer (BCa). However, the prognostic value of CIS in BCa is still not conclusive. Hence, we performed a systematic review and meta-analysis to explore the association between CIS and clinicopathological features and the prognostic value for BCa following radical cystectomy. METHODS We performed this study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies were systematically collected from PubMed, EMBASE, and Web of Science, with an expiration date of August 2018. Hazard ratios and 95% confidence intervals (CIs) were pooled to assess the intensity of association. All data were analyzed by Stata 12.0. Moreover, heterogeneity and publication bias were determined, and sensitivity analysis was performed to examine whether the findings of the meta-analysis were robust. RESULTS A total of 18,845 patients from 24 studies were included in the analysis. Our results indicated that CIS has no significant correlation with cancer-specific mortality (CSM) (pooled HR = 0.97, 95% CI 0.93-1.00, p = 0.059), overall mortality (OM) (pooled HR = 0.93, 95% CI 0.85-1.01, p = 0.076), overall survival (OS) (pooled HR = 1.04, 95% CI 0.96-1.12, p = 0.386), cancer-specific survival (CSS) (pooled HR = 1.06, 95% CI 0.97-1.16, p = 0.186), recurrence-free survival (RFS) (HR = 1.05, 95% CI 0.99-1.11, p = 0.098) or recurrence (pooled HR = 1.04, 95% CI 0.98-1.11, p = 0.212) in BCa patients. In addition, CIS was not correlated with gender (male vs. female, OR = 1.00, 95% CI 0.74-1.34, p = 0.978), pathological stage (III/IV vs. I/II: OR = 0.74, 95% CI 0.50-1.10, p = 0.132), tumor grade (1/2 vs. 3: OR = 3.38, 95% CI 0.73-15.65, p = 0.119), soft tissue surgical margin (STSM) (+ vs. - : OR = 1.20, 95% CI 0.97-1.48, p = 0.093) or lymphovascular invasion (LVI) (+ vs. - : OR = 0.92, 95% CI 0.62-1.38, p = 0.702),but was closely related to adjuvant chemotherapy (ACT) (yes vs. no, OR = 1.17, 95% CI 1.03-1.32, p = 0.019). Furthermore, these findings were demonstrated to be reliable by our sensitivity and subgroup analysis. CONCLUSIONS The prognostic value of CIS in BCa remains inconclusive in patients submitted to RC. Our data indicated that CIS may have no significant correlation with the prognosis and clinicopathological parameters of BCa patients, and also may not be applied to risk stratification or individualized therapy in BCa patients. Further research should be conducted to confirm our findings.
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Ohno Y. Role of systemic inflammatory response markers in urological malignancy. Int J Urol 2018; 26:31-47. [PMID: 30253448 DOI: 10.1111/iju.13801] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/20/2018] [Indexed: 12/14/2022]
Abstract
The systemic inflammatory response is associated with survival in patients with a variety of cancers. This inflammatory response is measured in the peripheral blood, and can be monitored using two categories of indices: concentration of specific serum proteins (albumin, C-reactive protein) and differential blood cell count (neutrophils, lymphocytes and platelets). Furthermore, combinations of these indices, such as the Glasgow Prognostic Score, which consists of the serum C-reactive protein and albumin level; the neutrophil-to-lymphocyte ratio; the platelet-to-lymphocyte ratio; and the prognostic nutritional index, which is based on peripheral blood lymphocyte count and serum albumin level, have also been evaluated and compared in cancer research. To date, there are hundreds of studies that have shown the prognostic value of systemic inflammatory response markers in patients with urological cancer. Most studies have evaluated the prognostic and predictive role of the pretreatment value of the markers, although some have focused on the role of the post-treatment value at specific points during the clinical course. The advantages of systemic inflammatory response markers are that they are easily measurable and inexpensive in the clinical setting. However, it is important to consider how clinicians use these markers in clinical practice. The present review provides a concise overview regarding systemic inflammatory markers in urological cancers, specifically C-reactive protein, Glasgow Prognostic Score/modified Glasgow Prognostic Score, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and prognostic nutritional index.
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Affiliation(s)
- Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Hsieh MC, Rau KM, Chiang PH, Sung MT, Lan J, Luo HL, Huang CC, Huang CH, Su HYL. Impact of Prognostic Nutritional Index on Overall Survival for Patients with Metastatic Urothelial Carcinoma. J Cancer 2018; 9:2466-2471. [PMID: 30026844 PMCID: PMC6036888 DOI: 10.7150/jca.25061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 04/17/2018] [Indexed: 12/25/2022] Open
Abstract
Background: Prognostic nutritional index (PNI) has been studied in various types of cancer which is significantly correlated with prognosis. The study aims to investigate the predictive role of PNI in patients with metastatic urothelial carcinoma (mUC) treated with systemic chemotherapy. Methods: We retrospectively reviewed 141 patients with mUC who received systemic chemotherapy. PNI was calculated as 10 × serum albumin concentration (g/dL) + 0.005 × lymphocyte count (number/mm2). The optimal cut-off value for PNI was estimated by using receiver operating curve analysis. Independent factors associated with progression-free survival (PFS) and overall survival (OS) were determined by Cox proportional regression models. Results: The recommended cut-off value for PNI was 40. Patients with a low PNI had more visceral metastases (p < 0.0001), leukocytosis (p = 0.006), and anemia (p < 0.0001). On univariate analysis, patients with a low PNI had poor OS than those with a high PNI (p < 0.0001). The multivariate analysis showed PNI was an independent factor to predict OS (p = 0.001). Conclusions: Our study showed PNI is an independent prognostic factor in patients with mUC. Our work is clinically useful for anticipation of outcomes, risks stratification in clinical studies as well as patients counseling.
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Affiliation(s)
- Meng-Che Hsieh
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Kun-Ming Rau
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Po-Hui Chiang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Ming-Tse Sung
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Jui Lan
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Hao-Lun Luo
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Chun-Chieh Huang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Cheng-Hua Huang
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan
| | - Harvey Yu-Li Su
- Division of Hematology Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Taiwan.,Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Taiwan
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Pu X, Zhu L, Fu Y, Fan Z, Zheng J, Zhang B, Yang J, Guan W, Wu H, Ye Q, Huang Q. Companied P16 genetic and protein status together providing useful information on the clinical outcome of urinary bladder cancer. Medicine (Baltimore) 2018; 97:e0353. [PMID: 29642177 PMCID: PMC5908565 DOI: 10.1097/md.0000000000010353] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SPEC P16/CEN3/7/17 Probe fluorescence-in-situ-hybridization (FISH) has become the most sensitive method in indentifying the urothelial tumors and loss of P16 has often been identified in low-grade urothelial lesions; however, little is known about the significations of other P16 genetic status (normal and amplification) in bladder cancer.We detected P16 gene status by FISH in 259 urine samples and divided these samples into 3 groups: 1, normal P16; 2, loss of P16; and 3, amplified P16. Meanwhile, p16 protein expression was measured by immunocytochemistry and we characterized the clinicopathologic features of cases with P16 gene status.Loss of P16 occurred in 26.2%, P16 amplification occurred in 41.3% and P16 gene normal occurred in 32.4% of all cases. P16 genetic status was significantly associated with tumor grade and primary tumor status (P = .008 and .017), but not with pathological tumor stage, overall survival, and p16 protein expression. However, P16 gene amplification accompanied protein high-expression has shorter overall survival compared with the overall patients (P = .023), and P16 gene loss accompanied loss of protein also had the tendency to predict bad prognosis (P = .067).Studies show that the genetic status of P16 has a close relation with the stages of bladder cancer. Loss of P16 is associated with low-grade urothelial malignancy while amplified P16 donotes high-grade. Neither P16 gene status nor p16 protein expression alone is an independent predictor of urothelial bladder carcinoma, but combine gene and protein status together providing useful information on the clinical outcome of these patients.
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Affiliation(s)
- Xiaohong Pu
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Liya Zhu
- Department of Blood Purification Center, Huan’an First People's Hospital, Nanjing Medical University, Jiangsu, China
| | - Yao Fu
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Zhiwen Fan
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Jinyu Zheng
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Biao Zhang
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Jun Yang
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Wenyan Guan
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Hongyan Wu
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Qing Ye
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
| | - Qing Huang
- Department of Pathology, Nanjing University Medical School affiliated Drum Tower Hospital, Nanjing
- Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, West Roxbury, MA
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The role of the systemic inflammatory response in predicting outcomes in patients with operable cancer: Systematic review and meta-analysis. Sci Rep 2017; 7:16717. [PMID: 29196718 PMCID: PMC5711862 DOI: 10.1038/s41598-017-16955-5] [Citation(s) in RCA: 212] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/17/2017] [Indexed: 02/06/2023] Open
Abstract
Cancer remains a leading causes of death worldwide and an elevated systemic inflammatory response (SIR) is associated with reduced survival in patients with operable cancer. This review aims to examine the evidence for the role of systemic inflammation based prognostic scores in patients with operable cancers. A wide-ranging literature review using targeted medical subject headings for human studies in English was carried out in the MEDLINE, EMBASE, and CDSR databases until the end of 2016. The SIR has independent prognostic value, across tumour types and geographical locations. In particular neutrophil lymphocyte ratio (NLR) (n = 158), platelet lymphocyte ratio (PLR) (n = 68), lymphocyte monocyte ratio (LMR) (n = 21) and Glasgow Prognostic Score/ modified Glasgow Prognostic Score (GPS/mGPS) (n = 60) were consistently validated. On meta-analysis there was a significant relationship between elevated NLR and overall survival (OS) (p < 0.00001)/ cancer specific survival (CSS) (p < 0.00001), between elevated LMR and OS (p < 0.00001)/CSS (p < 0.00001), and elevated PLR and OS (p < 0.00001)/CSS (p = 0.005). There was also a significant relationship between elevated GPS/mGPS and OS (p < 0.00001)/CSS (p < 0.00001). These results consolidate the prognostic value of the NLR, PLR, LMR and GPS/mGPS in patients with resectable cancers. This is particularly true for the NLR/GPS/mGPS which should form part of the routine preoperative and postoperative workup.
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Lozano Martínez AJ, Moreno Cano R, Escobar Páramo S, Salguero Aguilar R, Gonzalez Billalabeitia E, García Fernández R, De La Fuente Muñoz I, Romero Borque A, Porras Martínez M, Lopez Soler F, Cardenas Cánovas E, Ortega Martín I. Platelet-lymphocyte and neutrophil-lymphocyte ratios are prognostic but not predictive of response to abiraterone acetate in metastatic castration-resistant prostate cancer. Clin Transl Oncol 2017; 19:1531-1536. [PMID: 28718070 DOI: 10.1007/s12094-017-1699-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 06/02/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE Recently neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been reported to be inflammatory parameters that confer poorer outcome in metastatic castration-resistant prostate cancer (mCPRPC). However, these ratios have not been analyzed in patients treated with abiraterone acetate. We explored the relationship between different values of PLR and NLR and survival in mCPRCP treated with abiraterone and their possible relation with a prostate specific antigen (PSA) response. METHODS We retrospectively analyzed 101 patients with mCRPC treated with abiraterone from January of 2012 to November of 2015 in two different hospitals. A cut-off value of 5 for NLR and 150 for PLR were used to compare survival by Kaplan-Meier method. Moreover, an association between these cut-off values and the PSA response was analyzed by a χ 2 test. RESULTS In the case of NLR, the median DFS were 12, 1 months for NLR <5 and 7 months for NLR ≥5, p = 0.061. The median OS were 23.9 months for NLR <5 and 16.3 months for NLR ≥5, p = 0.046. In the case of PLR, the median DFS were 11.8 months for PLR <150 and 10.6 months for PLR ≥150, p = 0.549. The median OS were 27.4 months for PLR <150 and 15.9 months for PLR ≥150, p = 0.005. It was not observed a correlation between the different cut-off values of PLR or NLR and a PSA response ≥25% (p = 0.31). CONCLUSIONS It is shown a better prognostic relationship between PLR and NLR low values and OS that is statistically significant in mCPRC patients treated with abiraterone. Furthermore, it was not shown a relation between PLR and NLR values and PSA response.
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Affiliation(s)
- A J Lozano Martínez
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain.
| | - R Moreno Cano
- Medical Physicist Service, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - S Escobar Páramo
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - R Salguero Aguilar
- Medical Oncology Department, H.C.U. Morales Messeguer, Av Marqués de los Vélez, s/n, CP 30008, Murcia, Spain
| | - E Gonzalez Billalabeitia
- Medical Oncology Department, H.C.U. Morales Messeguer, Av Marqués de los Vélez, s/n, CP 30008, Murcia, Spain
| | - R García Fernández
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - I De La Fuente Muñoz
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - A Romero Borque
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - M Porras Martínez
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - F Lopez Soler
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - E Cardenas Cánovas
- Radiation Oncology Department, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
| | - I Ortega Martín
- Medical Physicist Service, H.C.U. Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, CP 30120, Murcia, Spain
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Dolan RD, McMillan DC. Neutrophil-to-lymphocyte ratio as a bladder cancer biomarker: Assessing prognostic and predictive value in SWOG 8710. Cancer 2017; 123:3855. [PMID: 28665479 DOI: 10.1002/cncr.30872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 06/13/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Ross D Dolan
- Department of Surgery, Victoria Infirmary, Glasgow Royal Infirmary, Glasgow, Scotland
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, Scotland
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Martha O, Porav-Hodade D, Bălan D, Tătaru OS, Sin A, Chibelean CB, Vartolomei MD. Easily Available Blood Test Neutrophil-To-Lymphocyte Ratio Predicts Progression in High-Risk Non-Muscle Invasive Bladder Cancer. REV ROMANA MED LAB 2017. [DOI: 10.1515/rrlm-2017-0016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Introduction: The inflammatory response surrounding the tumour has a major importance in the oncologic outcome of bladder cancers. One marker proved to be useful and accessible is NLR (neutrophil-to-lymphocyte ratio). The objective of the study was the analysis of NLR as a prognostic factor for recurrence and progression in pT1a and pT1b bladder cancers.
Material and Methods: Retrospective study, with 44 T1a/T1b bladder cancer patients. Each patient underwent transurethral resection. NLR was considered altered if higher than 3, average follow-up period was of 18 months.
Results: The mean age of the patients included was 73 years (IQR 64 - 77). Most of the patients had NLR<3 (30 patients). In total 29/44 (65.9 %) patients presented recurrence and 15/44 (34.1 %) patients were identified with T2 or higher stage progression during the follow-up period (average 18 months).We found no statistically significant association between NLR>3 and other clinic and pathologic factors. Progression-free survival (PFS) Kaplan-Meier analysis showed a lower PFS in the NLR>3 group, with a p=0.001 value. A total of 64.3% of patients had shown progression in the NLR>3 group and 20% in the NLR<3 group. Mean NLR was 2.67 (IQR 1.88-3.5); 2.50 (IQR 1.89-2.87) in patients that did not present any progression during the follow-up and 3.20 (IQR 1.73-5.80) in those with progression (p=0.09), ROC 0.655. Mean NLR was 2.14 (IQR 1.61-2.77) in patients that did not experience a recurrence during the follow-up and 2.76 (IQR 2.1-4.31) in those with recurrence, ROC 0.671 (p=0.06). Multivariable Cox regression analyses showed that stage T1b and NLR represent independent prognostic factors for PFS.
Conclusion: High Neutrophil-to-Lymphocyte ratio retained a statistically significant value, as an independent prognostic factor for bad prognosis of T1 bladder tumors. NLR represents a biomarker that could support a clinical decision making in case of high-risk on-muscle invasive bladder cancer.
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Affiliation(s)
- Orsolya Martha
- Department of Urology, University of Medicine and Pharmacy , Târgu Mureș , Romania
| | - Daniel Porav-Hodade
- Department of Urology, University of Medicine and Pharmacy , Târgu Mureș , Romania
| | - Daniel Bălan
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy , Târgu Mureș , Romania
| | | | - Anca Sin
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy , Târgu Mureș , Romania
| | | | - Mihai Dorin Vartolomei
- Department of Cell and Molecular Biology, University of Medicine and Pharmacy , Târgu Mureș , Romania
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Huang TB, Mao SY, Lu SM, Yu JJ, Luan Y, Gu X, Liu H, Zhou GC, Ding XF. Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of prostate cancer among men who underwent template-guided prostate biopsy: A STROBE-compliant study. Medicine (Baltimore) 2016; 95:e5307. [PMID: 27858908 PMCID: PMC5591156 DOI: 10.1097/md.0000000000005307] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) in diagnosis of prostate cancer (PCa). Data of 662 patients who underwent prostate biopsy from January 2012 to June 2016 were retrospectively reviewed. The receiver operating characteristic-derived area under the curve analyses were performed to assess the predictive accuracy. Simultaneously, Youden's index was calculated to determine the optimal NLR cutoff. Furthermore, univariate and multivariate logistic regression analyses were performed to determine the association between NLR value and PCa detection. On account of an NLR value of 2.44 was shown with the maximal Youden's index on the receiver operating characteristic curve, the cutoff value of NLR was set at 2.44. Accordingly, patients were classified into high-NLR or low-NLR group. The patients in high-NLR group might have significant higher risk to be diagnosed with PCa (HR 1.640; P = 0.031), especially in the subgroup with prostate-specific antigen (PSA) ranged from 4 to 10 ng mL (hazard ratio [HR] 4.364; P = 0.003). The high-NLR was independent of age of diagnosis, PSA, prostate volume, abnormal digital rectal examination, and hypoechoic lesion on transrectal ultrasound for positive prostate biopsy. In the so-called gray area, combination of NLR value could raise 4.6% of the accuracy of the multivariate logistic model in PCa prediction, but not in advanced PCa prediction.The patients with high-NLR value may have significant higher risk to be diagnosed with PCa, especially among the patients with PSA ranged from 4 to 10 ng mL. In this subgroup, the adding of NLR value in the multivariate model can improve the accuracy of PCa prediction in a large degree. If validated, the NLR will become a promising, accessible, inexpensive biomarker for PCa prediction.
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Affiliation(s)
- Tian-bao Huang
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Shi-yu Mao
- Department of Urology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Sheng-ming Lu
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Jun-jie Yu
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Yang Luan
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Xiao Gu
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
| | - Hao Liu
- Department of General Surgery, Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Guang-chen Zhou
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
- Correspondence: Xue-fei Ding, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: ); Guang-chen Zhou, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: )
| | - Xue-fei Ding
- Department of Urology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China
- Department of Urology, College of Clinical Medicine, Yangzhou, Jiangsu Province, China
- Correspondence: Xue-fei Ding, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: ); Guang-chen Zhou, No. 98 West Nantong Road, Yangzhou, 225001, Jiangsu Province, China (e-mail: )
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Deng Y, Pang Q, Miao RC, Chen W, Zhou YY, Bi JB, Liu SS, Zhang JY, Qu K, Liu C. Prognostic significance of pretreatment albumin/globulin ratio in patients with hepatocellular carcinoma. Onco Targets Ther 2016; 9:5317-28. [PMID: 27601923 PMCID: PMC5005008 DOI: 10.2147/ott.s109736] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Pretreatment nutritional and immunological statuses play an indispensable role in predicting the outcome of patients with various types of malignancies. The purpose of this study is to evaluate the predictive value of albumin/globulin ratio (AGR) in overall survival (OS) and recurrence in patients with hepatocellular carcinoma (HCC) following radical hepatic carcinectomy. PATIENTS AND METHODS This retrospective study included a total of 172 patients with HCC with complete medical and follow-up information between 2002 and 2012. AGR was calculated according to the following formula: AGR = albumin/globulin. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff value. The associations of AGR with clinicopathological characteristics and prognosis were assessed. Further multivariate analysis using Cox regression model and subgroup analysis was performed to evaluate the predictive value. RESULTS Receiver operating characteristic curve determined 37.65, 31.99, and 1.48 as the optimal cutoff values of albumin, globulin, and AGR in terms of 5-year OS or death, respectively. On the basis of the cutoff value of AGR, all the patients were divided, respectively, into low-AGR (n=105) and high-AGR (n=67) groups. AGR was found to be significantly correlated with age, cancer embolus, international normalized ratio, and postoperative outcome (P<0.05). Hepatitis B virus infection (hazard ratio [HR]: 2.125; 95% confidence interval [CI]: 1.285-3.153), tumor node metastasis stage (HR: 1.656; 95% CI: 1.234-2.223), serum albumin (HR: 0.546; 95% CI: 0.347-0.857), and AGR (HR: 0.402; 95% CI: 0.233-0.691) were independent predictors of OS via univariate and multivariate survival analyses. However, alpha-fetoprotein (HR: 1.708; 95% CI: 1.027-2.838), tumor node metastasis stage (HR: 1.464; 95% CI: 1.078-1.989), and AGR (HR: 0.493; 95% CI: 0.293-0.828) functioned as independent risk variables for predicting recurrence. Moreover, AGR showed superior prognostic value for OS and recurrence in the subgroups with normal level of albumin or survival time beyond 6 months. CONCLUSION Pretreatment AGR might serve as an effective biomarker to evaluate the prognosis of patients with a diagnosis of HCC. Based on the results, AGR, characterized with easy accessibility, objectivity, and noninvasiveness, should be included in the routine assessment of HCC.
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Affiliation(s)
- Yan Deng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Qing Pang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Run-Chen Miao
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Wei Chen
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Yan-Yan Zhou
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Jian-Bin Bi
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Su-Shun Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Jing-Yao Zhang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Kai Qu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
| | - Chang Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China
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Di Lorenzo G, Pagliuca M, Perillo T, Zarrella A, Verde A, De Placido S, Buonerba C. Complete Response and Fatigue Improvement With the Combined Use of Cyclophosphamide and Quercetin in a Patient With Metastatic Bladder Cancer: A Case Report. Medicine (Baltimore) 2016; 95:e2598. [PMID: 26844468 PMCID: PMC4748885 DOI: 10.1097/md.0000000000002598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Bladder cancer is a major cause of cancer-related mortality, with an estimated 74,000 new cases and 16,000 deaths in the United States in 2015. In patients with metastatic disease, vinflunine and taxanes are the most widely used chemotherapy agents in the second-line setting after failure of platinum-based treatment. Cyclophosphamide has been used in combination with paclitaxel in urothelial carcinoma of the bladder, but there are no data about the effectiveness of cyclophosphamide administered as a single agent.We here describe the first case of an advanced bladder cancer patient suffering from grade 2 fatigue.He benefited from administration of third-line single-agent metronomic oral cyclophosphamide plus oral doses of quercetin. A complete, prolonged radiologic response according to the RECIST criteria 1.1 was achieved with minimal toxicity and an improvement in fatigue.Further studies are required to assess the potential benefits associated with the combined use of cyclophosphamide plus quercetin in advanced bladder cancer patients.
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Affiliation(s)
- Giuseppe Di Lorenzo
- From the Medical Oncology Unit, Department of Clinical Medicine, Federico II University, Naples, Italy
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Di Lorenzo G, Buonerba C, Bellelli T, Romano C, Montanaro V, Ferro M, Benincasa A, Ribera D, Lucarelli G, De Cobelli O, Sonpavde G, De Placido S. Third-Line Chemotherapy for Metastatic Urothelial Cancer: A Retrospective Observational Study. Medicine (Baltimore) 2015; 94:e2297. [PMID: 26705213 PMCID: PMC4697979 DOI: 10.1097/md.0000000000002297] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The prognosis of locally advanced (T3/T4 or N1) and metastatic disease urothelial carcinoma is poor. In this retrospective study, we reviewed data about patients receiving third-line chemotherapy for metastatic disease, in view of the lack of data in this setting.We retrospectively analyzed medical records of patients with a pathologic diagnosis of urothelial carcinoma treated with systemic chemotherapy for metastatic disease at 4 participating Institutions between January, 2010, and January, 2015. Cox proportional hazards regression was used to evaluate the association of the chemotherapy agent used versus others with overall survival, adjusted for 5 externally validated prognostic factors in advanced urothelial carcinoma.Of 182 patients that received first-line chemotherapy/adjuvant chemotherapy as defined above, 116 patients (63.73%) received second-line salvage treatment. Fifty-two patients were finally included in this analysis, whereas 9 were excluded due to missing data. Third-line chemotherapy was based on cyclophosphamide, platinum, vinflunine, taxanes, and gemcitabine in 16, 12, 11, 10, and 3 patients, respectively. Median PFS (progression-free survival) and OS (overall survival) of the population were 13 (10-17) and 31 (28-36) weeks. Single-agent cyclophosphamide was associated with a PFS of 18 (13-22) and an OS of 38 (33-41) weeks, whereas platinum-based combinations were associated with a PFS of 5 weeks and an OS of 8 weeks. Multivariate analysis showed improved survival in patients treated with cyclophosphamide (hazard ratio (HR) = 0.42; 95% CI: 0.20-0.89; P = 0.025) and a worse survival in those treated with platinum-based regimens (HR: 4.37; 95% CI = 1.95-9.77; P < 0.01).We observed a significantly longer overall survival in patients receiving single-agent cyclophosphamide, with few grade 3 to 4 toxicities. Further studies should assess the efficacy of metronomic single-agent cyclophosphamide in advanced lines of treatment, as it may yield a survival benefit with low costs and no detrimental effects on quality of life.
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Affiliation(s)
- Giuseppe Di Lorenzo
- From the Medical Oncology, University Federico II of Naples, Naples (GDL, CB, DR, SDP); Medical Oncology, Hospital "San Luca," Vallo della Lucania, Salerno (TB); ASL Napoli 3 SUD, Naples (CR); Istituto Oncologico del Sud, Naples (VM); Division of Urology, European Institute of Oncology, Milan (MF, ODC); Division of Urology, Hospital "San Luca," Vallo della Lucania, Salerno (AB); Department of Emergency and Organ Transplantation, Urology and Kidney Transplantation Unit, University of Bari, Bari, Italy (GL); Department of Urology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania (ODC); and Department of Medicine, Section of Hematology-Oncology, University of Alabama, Birmingham School of Medicine, Birmingham, AL (GS)
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Lucarelli G, Rutigliano M, Sanguedolce F, Galleggiante V, Giglio A, Cagiano S, Bufo P, Maiorano E, Ribatti D, Ranieri E, Gigante M, Gesualdo L, Ferro M, de Cobelli O, Buonerba C, Di Lorenzo G, De Placido S, Palazzo S, Bettocchi C, Ditonno P, Battaglia M. Increased Expression of the Autocrine Motility Factor is Associated With Poor Prognosis in Patients With Clear Cell-Renal Cell Carcinoma. Medicine (Baltimore) 2015; 94:e2117. [PMID: 26579829 PMCID: PMC4652838 DOI: 10.1097/md.0000000000002117] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Glucose-6-phosphate isomerase (GPI), also known as phosphoglucose isomerase, was initially identified as the second glycolytic enzyme that catalyzes the interconversion of glucose-6-phosphate to fructose-6-phosphate. Later studies demonstrated that GPI was the same as the autocrine motility factor (AMF), and that it mediates its biological effects through the interaction with its surface receptor (AMFR/gp78). In this study, we assessed the role of GPI/AMF as a prognostic factor for clear cell renal cell carcinoma (ccRCC) cancer-specific (CSS) and progression-free survival (PFS). In addition, we evaluated the expression and localization of GPI/AMF and AMFR, using tissue microarray-based immunohistochemistry (TMA-IHC), indirect immunofluorescence (IF), and confocal microscopy analysis.Primary renal tumor and nonneoplastic tissues were collected from 180 patients who underwent nephrectomy for ccRCC. TMA-IHC and IF staining showed an increased signal for both GPI and AMFR in cancer cells, and their colocalization on plasma membrane. Kaplan-Meier curves showed significant differences in CSS and PFS among groups of patients with high versus low GPI expression. In particular, patients with high tissue levels of GPI had a 5-year survival rate of 58.8%, as compared to 92.1% for subjects with low levels (P < 0.0001). Similar findings were observed for PFS (56.8% vs 93.3% at 5 years). At multivariate analysis, GPI was an independent adverse prognostic factor for CSS (HR = 1.26; P = 0.001), and PFS (HR = 1.16; P = 0.01).In conclusion, our data suggest that GPI could serve as a marker of ccRCC aggressiveness and a prognostic factor for CSS and PFS.
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Affiliation(s)
- Giuseppe Lucarelli
- From the Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari (GL, MR, VG, AG, SP, CB, PD, MB); Department of Pathology, University of Foggia, Foggia (FS, SC, PB); Department of Pathology, University of Bari (EM); Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari, Bari (DR); Department of Medical and Surgical Sciences, Clinical Pathology Unit, University of Foggia, Foggia (ER); Department of Emergency and Organ Transplantation-Nephrology, Dialysis and Transplantation Unit, University of Bari, Bari (MG, GL); Department of Urology, European Institute of Oncology, Milan (MF, OdC); and Department of Clinical Medicine, Medical Oncology Unit, Federico II University, Naples, Italy (CB, GDL, SDP)
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