1. A risk-group classification model in patients with bladder cancer under neoadjuvant cisplatin-based combination chemotherapy
- Author
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Nicola Longo, Daniela Terracciano, Francesco Del Giudice, Giuseppe Lucarelli, Angelo Porreca, Pasquale Ditonno, Angelo Luciano, Carlo Buonerba, Alessandro Antonelli, Vincenzo Caputo, Rocco Damiano, Pasquale Dolce, Michele Marchioni, Fabio Crocerossa, Paolo Gontero, Stefania Zamboni, Matteo Manfredi, Antonio Verde, Michele Battaglia, Dario Ribera, Francesco Porpiglia, Gennaro Musi, Francesco Cantiello, Andrea Minervini, Felice Crocetto, Ottavio De Cobelli, Giuseppe Celentano, Vincenzo Cosimato, Mihai Dorin Vartolomei, Nicolae Crisan, Andrea Mari, Giorgio Ivan Russo, Abdal Rahman Abu Farhan, Francesco Greco, Francesco Soria, Francesco Chiancone, Luca Scafuri, Paola Del Prete, Rodolfo Hurle, Pietro De Placido, Giuseppe Di Lorenzo, Sergio Facchini, Matteo Ferro, Riccardo Autorino, Sisto Perdonà, Gian Maria Busetto, Ferro, Matteo, Lucarelli, Giuseppe, de Cobelli, Ottavio, Dolce, Pasquale, Terracciano, Daniela, Musi, Gennaro, Porreca, Angelo, Busetto, Gian Maria, Del Giudice, Francesco, Soria, Francesco, Gontero, Paolo, Cantiello, Francesco, Damiano, Rocco, Crocerossa, Fabio, Abu Farhan, Abdal Rahman, Autorino, Riccardo, Vartolomei, Mihai Dorin, Marchioni, Michele, Mari, Andrea, Minervini, Andrea, Longo, Nicola, Celentano, Giuseppe, Chiancone, Francesco, Perdonà, Sisto, Del Prete, Paola, Ditonno, Pasquale, Battaglia, Michele, Zamboni, Stefania, Antonelli, Alessandro, Greco, Francesco, Russo, Giorgio Ivan, Hurle, Rodolfo, Crisan, Nicolae, Manfredi, Matteo, Porpiglia, Francesco, Ribera, Dario, De Placido, Pietro, Facchini, Sergio, Scafuri, Luca, Verde, Antonio, Di Lorenzo, Giuseppe, Cosimato, Vincenzo, Luciano, Angelo, Caputo, Vincenzo Francesco, Crocetto, Felice, and Buonerba, Carlo
- Subjects
Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,030232 urology & nephrology ,Cystectomy ,Neoadjuvant chemotherapy ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Medicine ,Survival rate ,Aged ,Retrospective Studies ,Cisplatin ,Chemotherapy ,Bladder cancer ,business.industry ,Cholesterol ,Combination chemotherapy ,General Medicine ,Middle Aged ,medicine.disease ,Radical cystectomy ,Urinary Bladder Neoplasms ,chemistry ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Female ,Lymphadenectomy ,business ,medicine.drug - Abstract
The objective of the current research was to explore the potential prognostic value of readily available clinical and pathologic variables in bladder cancer. The novel association found between cholesterol levels and prognosis may provide the rationale for exploring novel treatments. Patients included had histologically confirmed urothelial bladder cancer and were treated with at least 3 cycles of cisplatin-based neoadjuvant chemotherapy before radical cystectomy with lymphadenectomy. A total of 245 patients at low, intermediate and high risk, presenting with 0-1, 2 or 3-4 risk factors, including positive lymph nodes, Hb 12.8, NLR ≥2.7 and cholesterol levels ≥199, were included. Five-year cancer-specific survival rate was 0.67, 0.78 and 0.94 at high, intermediate and low risk, respectively. Total cholesterol levels at the time of cystectomy may represent a commonly assessable prognostic factor and may be incorporated in a clinically meaningful risk-group classification model.Lay abstract This present study assessed a large group of patients with urothelial bladder cancer treated with chemotherapy followed by radical cystectomy, to capture the predictive power of commonly collected clinical, pathological and biochemical factors. The design of the study highlighted that higher cholesterol levels at the time of cystectomy were associated with shorter cancer-specific survival. This finding suggests that high blood-cholesterol levels truly have a negative influence on surviving cancer. In conclusion, total cholesterol levels at the time of cystectomy may represent a commonly assessable prognostic factor and could be incorporated into a clinically meaningful and valuable risk-group classification model.
- Published
- 2021
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