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Giuseppe P, Francesco Pio B, Eros S, Emilio S, Koosha MS, Pierluigi R, Filippo G, Battista FG, Francesco R, Marco C, Angelo T, Nazario F, Marco R. The mental and emotional status after radical cystectomy and different urinary diversion orthotopic bladder substitution versus external urinary diversion after radical cystectomy: A propensity score-matched study. Int J Urol 2024. [PMID: 39316514 DOI: 10.1111/iju.15586] [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: 05/20/2024] [Accepted: 09/09/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVES The quality of life in patients undergoing radical cystectomy and urinary diversion is gaining importance. Nowadays a broad consensus about the best urinary diversion does not exist. This study presents an all-round analysis of the impact of two types of urinary diversion on life's psycho-social aspects in patients undergoing radical cystectomy. METHODS This is an observational, single-centre, prospective study. Eligible participants underwent radical cystectomy and urinary diversion for bladder cancer in our department from January 2020 and February 2024. Of 130 included patients, 90 (45 with Bricker's ureteroileocutaneostomy and 45 received orthotopic bladder replacement) patients were matched and the study groups were well balanced for the baseline-matched variables. Patients completed 4 questionnaires (EORTC QLQ-C30, PGWBI, HADS, PSQI) at three different times: before the surgical procedure, and at 3 and 12 months. RESULTS Time shows a statistically significant effect (p < 0.0005) on four of the five functional scales explored (Physical Functioning, Role Functioning, Emotional Functioning, Social Functioning), and for all the nine symptoms/items' scales (p < 0.0005) and the Global Health Status (p = 0.003) in EORTC QLQ-C30. Neobladder's group shows a statistically significant improvement on the scales of Physical Functioning, Role Functioning, and Social Functioning, and for symptoms of nausea (p = 0.0027), pain (p = 0.0005), dyspnea (p = 0.012), insomnia (p = 0.004), constipation (p = 0.003). CONCLUSION We do not find a better urinary diversion in absolute terms. Neobladder obtained better results only for specific items and features. The urinary diversion's choice must be made in concert by the patient, the caregiver, and health professionals with adequate counseling.
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Affiliation(s)
- Palermo Giuseppe
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Bizzarri Francesco Pio
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Scarciglia Eros
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Sacco Emilio
- Catholic University of Sacred Heart, Rome, Italy
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
- Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Moosavi Seyed Koosha
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Russo Pierluigi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Gavi Filippo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Filomena Giovanni Battista
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Rossi Francesco
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Campetella Marco
- Department of Urology, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy
| | - Totaro Angelo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Foschi Nazario
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
| | - Racioppi Marco
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Catholic University of Sacred Heart, Rome, Italy
- Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
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Basiri A, Zahir M, Soleimani M, Khoshdel AR, Tabibi A, Imen MS, Soheilipour A, Golshan S, Balafkan M, Parvin M, Shariat SF. Comparison of different urinary diversions after radical cystectomy in Iran: Assessment of health-related quality of life and financial burden in a Middle Eastern country. Urologia 2024; 91:276-283. [PMID: 37933834 DOI: 10.1177/03915603231209090] [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] [Indexed: 11/08/2023]
Abstract
OBJECTIVES To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran. PATIENTS AND METHODS In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly. RESULTS AND LIMITATIONS In total 187 patients were identified-orthotopic neobladder (ONB) (N = 75), ileal conduit (IC) (N = 57), and cutaneous ureterostomy (CU) (N = 55)-and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning (p = 0.003, 0.011, 0.045) as well as better body image (p < 0.001), lower short- and long-term financial burden (p = 0.034 and <0.001, respectively), marginally lower complication rate (p = 0.049), and better 5-year overall survival (p < 0.001), in comparison with other UDs. Patients who underwent CU had the lowest HRQOL and worst survival. Limitations were retrospective design and possibility of selection bias. CONCLUSIONS In this first study that assesses a Middle Eastern collective; ONB seems to be the UD of choice with regard to HRQOL and economic burden when there is no contraindication.
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Affiliation(s)
- Abbas Basiri
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Erfan Hospital, Tehran, Iran
| | - Mazyar Zahir
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Urology and Nephrology Research Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Tabibi
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Sajjad Imen
- Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Soheilipour
- Clinical Research Development Center, Shahid Modarres Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shabnam Golshan
- Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mahmoud Parvin
- Department of Pathology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Praga, Czech Republic
- Division of Urology, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
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3
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Zhang W, Huang X, Lin B, Zheng W, Ke Z, Lin X, Chen J, Cai H, Lin Y, Chen Y, Zheng Q, Wei Y, Xue X, Li X, Xu N. The effect of body mass index on quality of life in modified single stoma cutaneous ureterostomy or ileal conduit after radical cystectomy. Cancer Med 2023; 12:20930-20939. [PMID: 37902236 PMCID: PMC10709730 DOI: 10.1002/cam4.6638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE To explore the influence of postoperative body mass index (BMI) change on postoperative quality of life (QOL) in patients undergoing radical cystectomy (RC) plus modified single stoma cutaneous ureterostomy (MSSCU) or ileal conduit (IC). METHODS Patients were divided into two groups according to different BMI change patterns: patients experiencing an elevated postoperative BMI level, along with a clinically significant increase in their BMI (an increase of more than 10%) were categorized as Group 1, while patients experiencing a decrease postoperative BMI level, along with a clinically significant reduction in their BMI (a decrease of more than 5%) were categorized as Group 2. Spearman correlation analysis was used to examine the correlations between quality-of-life scores and postoperative clinical parameters. RESULTS Spearman correlation analysis showed that postoperative BMI, late complications and catheter-free state were significantly associated with postoperative global QoL and symptom scale in MSSCU and postoperative global QoL and physical scale in IC patients. Additionally, postoperative BMI, catheter-free state and the use of adjuvant therapy were associated with bad performance in many scales of QoL like body image, future perspective, social scale, future perspective (MSSCU), and abdominal bloating (IC) (Table 2, p<0.05). Patients in Group 2 with significant weight loss had a better Global QoL, a lower rate of stomal stricture and a higher catheter-free state compared with those in Group 1 in both IC and MSSCU patients. MSSCU patients in Group 2 could achieve a comparable Global QoL as to IC patients in Group 1. CONCLUSION Controlling the substantial increase in body weight after surgery contributes to improving QoL, reducing the occurrence of stomal stricture, and ensuring a postoperative catheter-free state in BCa patients undergoing MSSCU.
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Affiliation(s)
- Wan‐Jin Zhang
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Xu‐Yun Huang
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Bin Lin
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Wen‐Cai Zheng
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Zhi‐Bin Ke
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Xiao‐Dan Lin
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Jia‐Yin Chen
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Hai Cai
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Yun‐Zhi Lin
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Ye‐Hui Chen
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Qing‐Shui Zheng
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Yong Wei
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Xue‐Yi Xue
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Xiao‐Dong Li
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Ning Xu
- Department of Urology, Urology Research Institute, The First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Department of Urology, National Region Medical centre, Binhai Campus of the First Affiliated HospitalFujian Medical UniversityFuzhouChina
- Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated HospitalFujian Medical UniversityFuzhouChina
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Paul CJ, Garje R, Kreder KJ, Mott SL, Gellhaus PT. Significant financial differences of chemical and surgical androgen deprivation in a contemporary cohort. Transl Androl Urol 2022; 11:1252-1261. [PMID: 36217391 PMCID: PMC9547165 DOI: 10.21037/tau-22-191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 08/08/2022] [Indexed: 01/13/2023] Open
Abstract
Background Androgen deprivation therapy (ADT) remains a cornerstone of treatment for advanced prostate cancer. Few men elect for surgical castration via bilateral orchiectomy. We sought to compare the relative difference in financial charges between chemical and surgical ADT in men. Methods Billing data was obtained for patients with metastatic prostate cancer receiving chemical ADT and who had bilateral orchiectomy from 2014-2019. Men had chosen intervention based on personal preference. We compared charges of ADT administration for chemical ADT and overall charges for bilateral orchiectomy. We determined the time chemical ADT patient charges surpassed those of surgical charges, as well as the net present value (NPV) of hypothetical savings for electing surgery over various ADT agents. Results One hundred and thirty-seven patients receiving chemical ADT and 7 patients who had undergone bilateral orchiectomy were analyzed. Median and mean surgical charges were $13,000. By 38 weeks following treatment initiation, 50% of chemical ADT patients had surpassed surgical charges, with 95% at 2 years. The NPV in savings for a median patient varied between ADT agent and was highest at $167,000 for leuprolide. Conclusions In less than a year, the median chemical ADT patient charges were greater than surgical castration. The NPV of electing surgery over ADT was the highest with leuprolide. Despite under-utilization, surgical castration remains a medically appropriate and cost-effective option for permanent ADT.
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Affiliation(s)
- Charles J. Paul
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Rohan Garje
- Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Karl J. Kreder
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Sarah L. Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Paul T. Gellhaus
- Department of Urology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
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Huang X, Jin S, Liu S, Geng J. Extreme body mass index is associated with poor survival outcomes after radical cystectomy: a retrospective cohort study in a Chinese population. Transl Androl Urol 2021; 10:3852-3861. [PMID: 34804827 PMCID: PMC8575586 DOI: 10.21037/tau-21-871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/20/2021] [Indexed: 11/20/2022] Open
Abstract
Background Body mass index (BMI) has been evidenced to be a significant prognostic factor in multiple cancers. This retrospective study aimed to investigate the association between BMI and survival outcomes after radical cystectomy (RC) in patients with bladder cancer (BCa). Methods Clinical and pathological parameters of patients who were diagnosed with BCa and received RC between 2010 and 2018 were collected. The associations between BMI at surgery and clinicopathological features were examined. The prognostic value of BCa for overall survival (OS) and cancer-specific survival (CSS) was examined using the Kaplan-Meier method and Cox regression models. Results Among the 217 patients enrolled in this study, 13 (6.0%), 121 (55.8%), 60 (27.6%), and 23 (10.6%) had a BMI value of <18.5 kg/m2 (underweight), 18.5–23.9 kg/m2 (normal), 24–27.9 kg/m2 (overweight), and ≥28 kg/m2 (obese), respectively. Underweight and obese patients tended to have poorer survival after RC than normal and overweight patients (P<0.05). Multivariable Cox regression revealed that extreme BMI was an independent predictor of both OS (BMI <18.5 vs. 18.5–27.9 kg/m2, OR =2.675, 95% CI: 1.131–6.327, P=0.025; BMI ≥28 vs. 18.5–27.9 kg/m2, OR =3.693, 95% CI: 1.589–8.583, P=0.002) and CSS (BMI <18.5 vs. 18.5–27.9 kg/m2, OR =3.012, 95% CI: 1.180–7.687, P=0.021; BMI ≥28 vs. 18.5–27.9 kg/m2, OR =3.801, 95% CI: 1.526–9.469, P=0.004), along with tumor stage and urinary diversion type. Conclusions Being underweight or obese is associated with a poor prognosis in patients with BCa undergoing RC. For patients who are preparing to undergo RC for BCa, controlling the BMI index through diet or exercise before surgery may contribute to the surgical curative effect and an improved prognosis.
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Affiliation(s)
- Xin Huang
- Clinical Medical College of Shanghai Tenth People's Hospital, Nanjing Medical University, Nanjing, China.,Department of Urology, Liyang People's Hospital, Liyang, China
| | - Shenye Jin
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Shenghua Liu
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jiang Geng
- Clinical Medical College of Shanghai Tenth People's Hospital, Nanjing Medical University, Nanjing, China.,Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
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Wang K, Gu Y, Ni J, Zhang H, Xie J, Xu T, Geng J, Mao W, Peng B. Combination of Total Psoas Index and Albumin-Globulin Score for the Prognosis Prediction of Bladder Cancer Patients After Radical Cystectomy: A Population-Based Study. Front Oncol 2021; 11:724536. [PMID: 34616677 PMCID: PMC8488353 DOI: 10.3389/fonc.2021.724536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background Sarcopenia as the loss of skeletal muscle mass is related with poor postoperative survival. This work purposed to evaluate the prognostic prediction of the total psoas index (TPI), albumin–globulin score (AGS), and the combination of TPI and AGS (CTA) in bladder cancer (BCa) patients after radical cystectomy. Methods BCa patients that received radical cystectomy between 2012 and 2020 were retrieved from our medical center. The calculation of TPI was based on the plain computed tomography images. The predictive effects of TPI, AGS, and CTA grade on survival of BCa patients were analyzed and compared with the albumin–globulin ratio (AGR) through the receiver operating characteristic (ROC) curves. A nomogram was further established based on the Cox regression results from CTA grade and clinicopathological characteristics, which are verified by the decision curve analysis (DCA). Results A total of 112 eligible patients diagnosed as BCa were included in this study for retrospective analysis. The patients with lower TPI or higher AGS grade (1/2) contained poorer overall survival (OS) and disease-free survival (DFS). Divided by CTA grade, there were 35 (31.25%) patients in grade 1 associated with the best postoperative prognosis, which was accompanied with increased TPI and decreased AGS. The CTA grade could better predict postoperative outcomes compared with TPI, AGR, and AGS for the highest area under the curve (AUC; 0.674 of OS and 0.681 of DFS). The 3- and 5-year OS and DFS nomograms were conducted based on CTA grade and clinical variables, with a higher predictive performance than the TNM stage. Conclusion This study revealed that the novel index CTA functioned as an effective prognostic predictor for postoperative OS and DFS of BCa patients after radical cystectomy. Preoperative assessment of CTA would contribute to optimizing clinical therapies.
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Affiliation(s)
- Keyi Wang
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, China.,Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yongzhe Gu
- Department of Neurology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinliang Ni
- Department of Urology, Tenth People's Hospital, Anhui Medical University, Shanghai, China
| | - Houliang Zhang
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinbo Xie
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tianyuan Xu
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiang Geng
- Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weipu Mao
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Bo Peng
- Department of Urology, Shanghai Shidong Hospital of Yangpu District, Shanghai, China.,Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Department of Urology, Tenth People's Hospital, Anhui Medical University, Shanghai, China
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