Introduction

Radical cystectomy (RC) represents the current standard for the curative treatment of localized muscle-invasive and high-risk BCG-refractory non-muscle invasive bladder cancer (BC). Besides its curative intention RC can be associated with a substantial postoperative morbidity compromising the oncological outcome. So far there is only limited data suggesting postoperative clinical and laboratory parameters that could predict the oncological outcome and the cancer specific survival (CSS), respectively. The aim of this study was to evaluate potential postoperative clinical and laboratory parameters to predict the oncological outcome of patients undergoing RC for BC. _x000D_ _x000D_

Methods

A single-centred retrospective data analysis of patients undergoing RC between 2004 and 2015 for BC was performed. Besides routine blood parameters (leucocytes, creatinine, Hb, CRP and thrombocytes), Clavien-classification, wound healing disorders (WD) and length of stay at the intensive care unit (ICU) were recorded. For all parameters a hazard ratio (HR) concerning the CSS was calculated on a univariate basis. Secondly a HR was calculated respecting the given postoperative parameters while including also postoperative staging (TNM-classification) parameters on a multivariate basis.

Results

In total 751 patients (n=751) with a complete dataset were identified. The HR concerning CSS was significant in univariate analysis for following parameters: creatinine-level (HR=1.34; p <0.001), CRP-level (HR=1.03; p0.031), thrombocyte count (HR=1.0002; p=0.037), post-operative WD (HR=1.85; p<0.001), Clavien-Score (1-3 vs. 3+) (HR=1.47;p= =0.027) and postoperative length of stay at the ICU (HR=2.84;p0.001). With the inclusion of the post-interventional TNM-classification the HR concerning CSS turned out to be significant on a multivariate analysis for TNM-values only. (pT<3 vs. pT3-4 HR=3.48, p =0.001; pN0 vs. pN+ HR=1.60, p =0.037 and M0 vs. M1 HR=2.44, p= 0.005). _x000D_ _x000D_

Conclusions

In univariate analysis routine postoperative blood parameters, such as creatinine, CRP and thrombocyte count seem to be associated with a decrease in CSS. A closer monitoring and potentially intervention in a postoperative setting might be beneficial for these patients. ICU inhabitancy and WD after RC also show a degrading tendency regarding CSS in our cohort. However, multivariate analysis respecting TNM information shows that the studied parameters are no independent predictive markers for CSS.

Funding

none