PURPOSE: To evaluate prognostic factors affecting local control (LC), distant metastases-free survival (DMFS) and overall survival (OS) in bladder carcinoma patients undergoing extravesical extension. PATIENTS AND METHODS: We retrospectively reviewed the charts of 61 consecutive patients with T3 or T4 bladder carcinoma, treated with definitive radiotherapy from 1999 through 2007. RESULTS: Median age was 69 years and follow-up was 29 months. The LC rate was 33% at 4 years and was increased in patients with a Hb< 12 g/dl (p= 0.003) or a LDH< 180 U/L (p= 0.021) and in those who received concurrent chemotherapy (p= 0.022) on univariate analysis. DMFS was affected by anemia (Hb< 12 g/dl) (p= 0.039), the absence of chemotherapy (p= 0.034) and the presence of newly-diagnosed disease (p= 0.01). The OS rate was 19% at 4 years. Non-pure transitional cell carcinoma histological type (p= 0.024), anemia (p= 0.004), elevated LDH (p= 0.003), and newly diagnosed disease (p= 0.011) were poor prognostic factors on univariate analyses for OS. Anemia was the only negative prognostic factor for LC (p= 0.03), DMFS (p= 0.002) and OS (p< 0.0001) on multivariate analysis. CONCLUSION: Pre-treatment Hb level is the most important prognostic factor in patients treated with definitive radiotherapy, so that anemia may act as a surrogate biological marker for aggressive disease.
PURPOSE: To evaluate prognostic factors affecting local control (LC), distant metastases-free survival (DMFS) and overall survival (OS) in bladder carcinomapatients undergoing extravesical extension. PATIENTS AND METHODS: We retrospectively reviewed the charts of 61 consecutive patients with T3 or T4 bladder carcinoma, treated with definitive radiotherapy from 1999 through 2007. RESULTS: Median age was 69 years and follow-up was 29 months. The LC rate was 33% at 4 years and was increased in patients with a Hb< 12 g/dl (p= 0.003) or a LDH< 180 U/L (p= 0.021) and in those who received concurrent chemotherapy (p= 0.022) on univariate analysis. DMFS was affected by anemia (Hb< 12 g/dl) (p= 0.039), the absence of chemotherapy (p= 0.034) and the presence of newly-diagnosed disease (p= 0.01). The OS rate was 19% at 4 years. Non-pure transitional cell carcinoma histological type (p= 0.024), anemia (p= 0.004), elevated LDH (p= 0.003), and newly diagnosed disease (p= 0.011) were poor prognostic factors on univariate analyses for OS. Anemia was the only negative prognostic factor for LC (p= 0.03), DMFS (p= 0.002) and OS (p< 0.0001) on multivariate analysis. CONCLUSION: Pre-treatment Hb level is the most important prognostic factor in patients treated with definitive radiotherapy, so that anemia may act as a surrogate biological marker for aggressive disease.
Authors: Tina Schubert; Tilman Todenhöfer; Johannes Mischinger; Christian Schwentner; Markus Renninger; Arnulf Stenzl; Georgios Gakis Journal: World J Urol Date: 2015-09-29 Impact factor: 4.226