OBJECTIVE: To evaluate the impact of the preoperative American Society of Anesthesiologists (ASA) score and serum albumin level on complications, recurrences and survival rates of patients who underwent radical cystectomy (RC) for urothelial bladder cancer (UBC). PATIENTS AND METHODS: In all, 1964 patients underwent RC for UBC at our institution between 1971 and 2008. Preoperative serum albumin and ASA score were available in 1471 and 1140 patients, respectively. A complication was defined as any surgery related/unrelated event leading to lengthening hospital stay or re-admission. Endpoints were 90-day complication (90dC) rate, recurrence-free survival (RFS) and overall survival (OS). RESULTS: The median (range) follow-up was 12.4 (0.2-27.3) years. In all, 197 patients (13.4%) had a low albumin level (<3.5 g/dL) and 740 (64.8%) had a high ASA score (3 or 4). Low serum albumin and a high ASA score were associated with higher 90dC rate (42% vs 34%, P = 0.03 and 40% vs 28%, P < 0.001, respectively). On multiple logistic regression analysis, a high ASA score remained independently associated with increased 90dC rate (hazard ratio [HR] 1.52, P = 0.005) and decreased OS (HR 1.45, 95% confidence interval [CI] 1.13-1.86). A low serum albumin level was also independently associated with RFS (HR 1.68, 95% CI 1.16-2.43) and OS (HR 1.93, 95% CI 1.43-2.63). CONCLUSION: A low serum albumin level was independently associated with cancer recurrence and decreased OS after RC. A high ASA score was also independently associated with decreased OS. These parameters potentially could be used as prognosticators after RC.
OBJECTIVE: To evaluate the impact of the preoperative American Society of Anesthesiologists (ASA) score and serum albumin level on complications, recurrences and survival rates of patients who underwent radical cystectomy (RC) for urothelial bladder cancer (UBC). PATIENTS AND METHODS: In all, 1964 patients underwent RC for UBC at our institution between 1971 and 2008. Preoperative serum albumin and ASA score were available in 1471 and 1140 patients, respectively. A complication was defined as any surgery related/unrelated event leading to lengthening hospital stay or re-admission. Endpoints were 90-day complication (90dC) rate, recurrence-free survival (RFS) and overall survival (OS). RESULTS: The median (range) follow-up was 12.4 (0.2-27.3) years. In all, 197 patients (13.4%) had a low albumin level (<3.5 g/dL) and 740 (64.8%) had a high ASA score (3 or 4). Low serum albumin and a high ASA score were associated with higher 90dC rate (42% vs 34%, P = 0.03 and 40% vs 28%, P < 0.001, respectively). On multiple logistic regression analysis, a high ASA score remained independently associated with increased 90dC rate (hazard ratio [HR] 1.52, P = 0.005) and decreased OS (HR 1.45, 95% confidence interval [CI] 1.13-1.86). A low serum albumin level was also independently associated with RFS (HR 1.68, 95% CI 1.16-2.43) and OS (HR 1.93, 95% CI 1.43-2.63). CONCLUSION: A low serum albumin level was independently associated with cancer recurrence and decreased OS after RC. A high ASA score was also independently associated with decreased OS. These parameters potentially could be used as prognosticators after RC.
Authors: Ettore Di Trapani; Rafael Sanchez-Salas; Giorgio Gandaglia; Lorenzo Rocchini; Marco Moschini; Daphne Lizee; Arie Carneiro; Arjun Sivaraman; Eric Barret; François Rozet; Marc Galiano; Mostefa Bennamoun; Renzo Colombo; Nazareno Suardi; Alberto Briganti; Francesco Montorsi; Xavier Cathelineau Journal: World J Urol Date: 2015-07-22 Impact factor: 4.226
Authors: V Rodrigues; F Landi; S Castro; R Mast; N Rodríguez; A Gantxegi; J Pradell; M López-Cano; M Armengol Journal: J Gastrointest Surg Date: 2020-07-13 Impact factor: 3.452
Authors: Yue Zhang; Fei Li; Fan Yang; Wen-Li Zeng; Hao Lin; Qi-Liang Zhai; Ming-Qiang Su; Zi-Hao Chen; Wan-Long Tan Journal: Nan Fang Yi Ke Da Xue Xue Bao Date: 2018-02-20
Authors: Pranav Sharma; Carl H Henriksen; Kamran Zargar-Shoshtari; Ren Xin; Michael A Poch; Julio M Pow-Sang; Wade J Sexton; Philippe E Spiess; Scott M Gilbert Journal: J Urol Date: 2015-07-31 Impact factor: 7.450