Shoji Kimura1, David D' Andrea2, Francesco Soria3, Beat Foerster4, Mohammad Abufaraj5, Mihai D Vartolomei6, Takehiro Iwata7, Pierre I Karakiewicz8, Michael Rink9, Kilian M Gust10, Shin Egawa11, Shahrokh F Shariat12. 1. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Jikei University School of Medicine, Tokyo, Japan. 2. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 3. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy. 4. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland. 5. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Special Surgery, Jordan University hospital, The University of Jordan, Amman, Jordan. 6. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania. 7. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 8. Division of Urology, University of Montreal Health Center, Montreal, QC, Canada. 9. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 10. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. 11. Department of Urology, Jikei University School of Medicine, Tokyo, Japan. 12. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. Electronic address: shahrokh.shariat@meduniwien.ac.at.
Abstract
PURPOSE: To investigate the prognostic value of preoperative modified Glasgow Prognostic Score (mGPS) in patients with non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of bladder with or without intravesical therapy. MATERIAL AND METHODS: We retrospectively reviewed our medical records to identify 1,096 consecutive patients with NMIBC treated with transurethral resection of bladder. The mGPS of each patient was calculated on the basis of preoperative serum C-reactive protein and albumin. Univariable and multivariable Cox regression analyses were performed to investigate the association of mGPS with recurrence-free survival (RFS) and progression-free survival (PFS). RESULTS: The mGPS of 0, 1, and 2 was observed in 764 (69.7%), 299 (27.3%), and 33 (3.0%) patients, respectively. On univariable analysis, mGPS 2 was associated with worse RFS (Hazard Ratio [HR]: 1.60, 95%; CI: 1.01-2.54). However, on multivariable analyses, which adjusted for the effects of established clinicopathologic features, mGPS 2 did not maintain its independent association with RFS (HR: 1.41, 95% CI: 0.88-2.26). On multivariable analysis, mGPS 1 and 2 were both independently associated with worse PFS compared to mGPS 0 (HR: 2.06, 95% CI: 1.37-3.12 and HR: 3.31, 95% CI: 1.40-7.87, respectively). The inclusion of mGPS improved the discrimination of a standard prognostic model for PFS from 71.6% to 73.8%. In subgroup analyses, mGPS 1 was associated with PFS (HR 2.09, 95% CI: 1.24-3.52) on multivariable analysis in patients with the European Association of Urology high-risk group. Additionally, in patients treated with bacillus Calmette-Guérin, mGPS 2 was associated with disease PFS (HR10.1, 95% CI: 2.61-38.8). CONCLUSIONS: The mGPS independently predicts PFS in patients with NMIBC. Inclusion of mGPS in prognostic models might help identify patients who are more likely to fail standard therapy and experience disease progression and, therefore, may benefit from intensified therapy such as radical cystectomy or inclusion in clinical trials of novel immunotherapeutics.
PURPOSE: To investigate the prognostic value of preoperative modified Glasgow Prognostic Score (mGPS) in patients with non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of bladder with or without intravesical therapy. MATERIAL AND METHODS: We retrospectively reviewed our medical records to identify 1,096 consecutive patients with NMIBC treated with transurethral resection of bladder. The mGPS of each patient was calculated on the basis of preoperative serum C-reactive protein and albumin. Univariable and multivariable Cox regression analyses were performed to investigate the association of mGPS with recurrence-free survival (RFS) and progression-free survival (PFS). RESULTS: The mGPS of 0, 1, and 2 was observed in 764 (69.7%), 299 (27.3%), and 33 (3.0%) patients, respectively. On univariable analysis, mGPS 2 was associated with worse RFS (Hazard Ratio [HR]: 1.60, 95%; CI: 1.01-2.54). However, on multivariable analyses, which adjusted for the effects of established clinicopathologic features, mGPS 2 did not maintain its independent association with RFS (HR: 1.41, 95% CI: 0.88-2.26). On multivariable analysis, mGPS 1 and 2 were both independently associated with worse PFS compared to mGPS 0 (HR: 2.06, 95% CI: 1.37-3.12 and HR: 3.31, 95% CI: 1.40-7.87, respectively). The inclusion of mGPS improved the discrimination of a standard prognostic model for PFS from 71.6% to 73.8%. In subgroup analyses, mGPS 1 was associated with PFS (HR 2.09, 95% CI: 1.24-3.52) on multivariable analysis in patients with the European Association of Urology high-risk group. Additionally, in patients treated with bacillus Calmette-Guérin, mGPS 2 was associated with disease PFS (HR10.1, 95% CI: 2.61-38.8). CONCLUSIONS: The mGPS independently predicts PFS in patients with NMIBC. Inclusion of mGPS in prognostic models might help identify patients who are more likely to fail standard therapy and experience disease progression and, therefore, may benefit from intensified therapy such as radical cystectomy or inclusion in clinical trials of novel immunotherapeutics.
Authors: Jacqueline T Brown; Yuan Liu; Julie M Shabto; Dylan J Martini; Deepak Ravindranathan; Emilie Elise Hitron; Greta Anne Russler; Sarah Caulfield; Lauren Beth Yantorni; Shreyas S Joshi; Haydn Kissick; Kenneth Ogan; Wayne B Harris; Bradley C Carthon; Omer Kucuk; Viraj A Master; Mehmet Asim Bilen Journal: Oncologist Date: 2021-03-18
Authors: Victor M Schuettfort; David D'Andrea; Fahad Quhal; Hadi Mostafaei; Ekaterina Laukhtina; Keiichiro Mori; Frederik König; Michael Rink; Mohammad Abufaraj; Pierre I Karakiewicz; Stefano Luzzago; Morgan Rouprêt; Dmitry Enikeev; Kristin Zimmermann; Marina Deuker; Marco Moschini; Reza Sari Motlagh; Nico C Grossmann; Satoshi Katayama; Benjamin Pradere; Shahrokh F Shariat Journal: BJU Int Date: 2021-04-07 Impact factor: 5.969
Authors: Matteo Ferro; Marina Di Mauro; Sebastiano Cimino; Giuseppe Morgia; Giuseppe Lucarelli; Abdal Rahman Abu Farhan; Mihai Dorin Vartolomei; Angelo Porreca; Francesco Cantiello; Rocco Damiano; Gian Maria Busetto; Francesco Del Giudice; Rodolfo Hurle; Sisto Perdonà; Marco Borghesi; Pierluigi Bove; Riccardo Autorino; Nicolae Crisan; Michele Marchioni; Luigi Schips; Francesco Soria; Andrea Mari; Andrea Minervini; Alessandro Veccia; Michele Battaglia; Daniela Terracciano; Gennaro Musi; Giovanni Cordima; Matteo Muto; Vincenzo Mirone; Ottavio de Cobelli; Giorgio Ivan Russo Journal: Transl Androl Urol Date: 2021-02