Tahir Qayyum1, Peter McArdle2, Mustafa Hilmy2, James Going3, Clare Orange4, Morag Seywright4, Paul Horgan5, Mark Underwood2, Joanne Edwards1. 1. Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, UK. 2. Department of Urology, Royal Infirmary, Glasgow, UK. 3. University Department of Pathology, Royal Infirmary, Glasgow, UK. 4. Department of Pathology, Western Infirmary, Glasgow, UK. 5. School of Medicine, College of MVLS, University of Glasgow, Royal Infirmary, Glasgow, UK.
Abstract
INTRODUCTION: To examine the role of inflammation in bladder cancer, we assessed the relationship between a systemic inflammation prognostic score (modified Glasgow Prognostic Score, mGPS), the tumor inflammatory cell infiltrate as measured by the Klintrup-Makinen score and tumor necrosis with cancer specific survival in patients with bladder cancer. MATERIALS AND METHODS: The cohort consisted of 68 bladder cancer patients, 47 with localised disease and 21 with muscle invasive disease. The mGPS response was constructed by measuring C-reactive protein and albumin concentrations and the Klintrup-Makinen score was evaluated histologically for the local inflammatory response. Pathological parameters such as grade, T stage and tumor necrosis were also assessed. RESULTS: Median follow was 47 months and 24 patients died of their disease. On univariate analysis, T stage (p < 0.001), grade (p < 0.001) and mGPS (p = 0.002) were significant predictors of cancer specific survival. On multivariate analysis, T stage (hazard ratio 5.98, 95% confidence interval 3.18-11.24, p < 0.001) and mGPS (hazard ratio 1.78, 95% confidence interval 1.09-2.9, p = 0.02) were significant independent predictors of cancer specific survival. CONCLUSION: A preoperative systemic inflammatory response is an independent predictor of poor cancer specific survival in patients with bladder cancer.
INTRODUCTION: To examine the role of inflammation in bladder cancer, we assessed the relationship between a systemic inflammation prognostic score (modified Glasgow Prognostic Score, mGPS), the tumor inflammatory cell infiltrate as measured by the Klintrup-Makinen score and tumor necrosis with cancer specific survival in patients with bladder cancer. MATERIALS AND METHODS: The cohort consisted of 68 bladder cancerpatients, 47 with localised disease and 21 with muscle invasive disease. The mGPS response was constructed by measuring C-reactive protein and albumin concentrations and the Klintrup-Makinen score was evaluated histologically for the local inflammatory response. Pathological parameters such as grade, T stage and tumor necrosis were also assessed. RESULTS: Median follow was 47 months and 24 patients died of their disease. On univariate analysis, T stage (p < 0.001), grade (p < 0.001) and mGPS (p = 0.002) were significant predictors of cancer specific survival. On multivariate analysis, T stage (hazard ratio 5.98, 95% confidence interval 3.18-11.24, p < 0.001) and mGPS (hazard ratio 1.78, 95% confidence interval 1.09-2.9, p = 0.02) were significant independent predictors of cancer specific survival. CONCLUSION: A preoperative systemic inflammatory response is an independent predictor of poor cancer specific survival in patients with bladder cancer.
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