Mayr, Roman and May, Matthias and Burger, Maximilian and Martini, Thomas and Pycha, Armin and Dechet, Christopher and Lodde, Michele and Comploj, Evi and Wieland, Wolf F. and Denzinger, Stefan and Otto, Wolfgang and Aziz, Atiqullah and Fritsche, Hans-Martin and Gierth, Michael (2014) The Charlson Comorbidity Index Predicts Survival after Disease Recurrence in Patients following Radical Cystectomy for Urothelial Carcinoma of the Bladder. UROLOGIA INTERNATIONALIS, 93 (3). pp. 303-310. ISSN 0042-1138, 1423-0399
Full text not available from this repository. (Request a copy)Abstract
Objective:To identify prognostic clinical and histopathological parameters, including comorbidity indices at the time of radical cystectomy (RC), for overall survival (OS) after recurrence following RC for urothelial carcinoma of the bladder (UCB). Materials and Methods: A retrospective multicenter study was carried out in 555 unselected consecutive patients who underwent RC with pelvic lymph node dissection for UCB from 2000 to 2010. A total of 227 patients with recurrence comprised our study group. Cox proportional hazards regression models were calculated with established variables to assess their independent influence on OS after recurrence. Results: The median time from RC to recurrence and the median OS after recurrence was 10.9 and 5.4 months, respectively. Neither the time to recurrence nor the type of recurrence (systematic vs. local) was predictive of the OS. In contrast, age (hazard ratio (HR) 1.53, p = 0.011), lymph node metastasis (HR 1.56, p = 0.007), and positive surgical margins (HR 1.53, p = 0.046) significantly affected the OS after disease recurrence. In addition, the dichotomized Charlson comorbidity index (CCI; dichotomized into >2 vs. 0-2) was the only comorbidity score with an independent prediction of OS (HR 1.41, p = 0.033). We observed a significant gain in the base model's predictive accuracy, i.e. from 68.4 to 70.3% (p < 0.001), after inclusion of the dichotomized CCI. Conclusions: We present the first outcome study of comorbidity indices used as predictors of OS after disease recurrence in patients undergoing RC for UCB. The CCI at the time of RC had no significant influence on the time to recurrence but represented an independent predictor of OS after disease recurrence. (C) 2014 S. Karger AG, Basel
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CANCER-SPECIFIC MORTALITY; SERIES; Bladder cancer; Distant recurrence; Local recurrence; Time to recurrence; Outcome; Transitional cell carcinoma; Comorbidity scores |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Nov 2019 07:59 |
| Last Modified: | 29 Nov 2019 07:59 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10917 |
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