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Hofner, Thomas; Haferkamp, Axel; Knapp, Lena; Pahernik, Sascha; Hadaschik, Boris; Djakovic, Nenad; Wagener, Nina; Hohenfellner, Markus

Preoperative Hydronephrosis Predicts Advanced Bladder Cancer but Is Not an Independent Factor for Cancer-Specific Survival after Radical Cystectomy

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  • Media type: E-Article
  • Title: Preoperative Hydronephrosis Predicts Advanced Bladder Cancer but Is Not an Independent Factor for Cancer-Specific Survival after Radical Cystectomy
  • Contributor: Hofner, Thomas; Haferkamp, Axel; Knapp, Lena; Pahernik, Sascha; Hadaschik, Boris; Djakovic, Nenad; Wagener, Nina; Hohenfellner, Markus
  • imprint: S. Karger AG, 2011
  • Published in: Urologia Internationalis, 86 (2011) 1, Seite 25-30
  • Language: English
  • DOI: 10.1159/000321008
  • ISSN: 0042-1138; 1423-0399
  • Keywords: Urology
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;i&gt;Introduction:&lt;/i&gt; Hydronephrosis and BMI are analyzed together with established factors such as TNM stage and surgical margins in a multivariate modality to investigate their status as independent prognostic factors for bladder cancer-specific survival in patients undergoing radical cystectomy. &lt;i&gt;Patients and Methods:&lt;/i&gt; We studied a prospective cohort of 328 patients who underwent radical cystectomy for bladder cancer at our institution. Statistical analyses were performed using the Kaplan-Meier method, Kendall-tau rank correlation and multivariate Cox proportional hazard model. &lt;i&gt;Results:&lt;/i&gt; Hydronephrosis was positively correlated with advanced tumor stage, positive lymph node involvement and positive surgical margins. Adjusted for all other investigated parameters, BMI and hydronephrosis did not affect cancer-specific survival. In multivariate analysis only non-organ-confined disease (HR: 1.40, 95% CI: 1.04–1.87, p = 0.024), positive lymph node stage (HR 1.71: 95% CI: 1.12–2.61, p = 0.013) and positive surgical margins (HR 3.00, 95% CI: 1.74–5.15, p &lt; 0.001) were prognostic factors. &lt;i&gt;Conclusions:&lt;/i&gt; Hydronephrosis at the time of radical cystectomy is significantly correlated with the presence of more advanced bladder cancer and positive surgical margins. However, the long-established parameters pT stage, pN stage and surgical margins predominantly influence cancer-specific survival for patients undergoing radical cystectomy irrespective of hydronephrosis and BMI status.</jats:p>