Effect of decreased renal function on poor oncological outcome after radical cystectomy

Investig Clin Urol. 2023 Jul;64(4):346-352. doi: 10.4111/icu.20230063.

Abstract

Purpose: To evaluate the impact of preoperative renal impairment on the oncological outcomes of patients with urothelial carcinoma who underwent radical cystectomy.

Materials and methods: We retrospectively reviewed the medical records of patients with urothelial carcinoma who underwent radical cystectomy from 2004 to 2017. All patients who underwent preoperative 99mTc-diethylenetriaminepentaacetic acid renal scintigraphy (DTPA) were identified. We divided the patients into two groups according to their glomerular filtration rates (GFRs): GFR group 1, GFR≥90 mL/min/1.73 m²; GFR group 2, 60≤GFR<90 mL/min/1.73 m². We included 89 patients in GFR group 1 and 246 patients in GFR group 2 and compared the clinicopathological characteristics and oncological outcomes between the two groups.

Results: The mean time required for recurrence was 125.5±8.0 months in GFR group 1 and 85.7±7.4 months in GFR group 2 (p=0.030). The mean cancer-specific survival was 131.7±7.8 months in GFR group 1 and 95.5±6.9 months in GFR group 2 (p=0.051). The mean overall survival was 123.3±8.1 months in GFR group 1 and 79.5±6.6 months in GFR group 2 (p=0.004).

Conclusions: Preoperative GFR values in the range of 60≤GFR<90 mL/min/1.73 m² are independent prognostic factors for poor recurrence-free survival, cancer-specific survival, and overall survival in patients after radical cystectomy compared with GFR values of ≥90 mL/min/1.73 m².

Keywords: Bladder cancer; Glomerular filtration rates; Patient outcome assessment.

MeSH terms

  • Carcinoma, Transitional Cell* / diagnostic imaging
  • Carcinoma, Transitional Cell* / surgery
  • Cystectomy / adverse effects
  • Humans
  • Kidney
  • Retrospective Studies
  • Urinary Bladder Neoplasms* / diagnostic imaging
  • Urinary Bladder Neoplasms* / pathology
  • Urinary Bladder Neoplasms* / surgery