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Impact of preoperative hemoglobin and CRP levels on cancer-specific survival in patients undergoing radical cystectomy for transitional cell carcinoma of the bladder: results of a single-center study

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A Letter to the Editor to this article was published on 27 July 2016

Abstract

Purpose

Different blood parameters have shown to be associated with patient’s oncological outcome. There is only limited knowledge about the prognostic relevance of routine blood parameters in patients undergoing radical cystectomy for transitional cell carcinoma (TCC). Therefore, we retrospectively analyzed the influence of preoperative C-reactive protein (CRP) and hemoglobin (Hb) levels on overall survival (OS) and cancer-specific survival (CSS).

Materials and methods

Preoperative CRP and Hb levels were available in 664 patients who underwent RC due to TCC from 2004 to 2013 at our institution. More men than women (77 vs. 23 %) underwent surgery with a median age of 70 years (35–97). Median follow-up time was 24 months (max. 108). Outcome was analyzed using Kaplan–Meier method, log-rank test, and Cox regression models.

Results

Median CRP level was 0.5 mg/dl (0.1–28.3), and median Hb level was 13.4 g/dl (6.7–17.9). Patients with CRP value above the median died significantly earlier due to their disease than those with CRP below the median (median CSS 19 vs. 70 months; p < 0.001). Patients with preoperative Hb level below the median had significantly worse outcome than those with Hb level above the median (median CSS 25 vs. 78 months; p < 0.001). In multivariate analysis, CRP and Hb levels were independent prognostic parameters regarding CSS/OS (CRP p = 0.016/p = 0.004; Hb p = 0.006/p = 0.004, respectively).

Conclusions

In our single-center study, preoperative CRP and Hb levels were found to be independent prognostic factors, indicating impaired outcome in patients undergoing RC for TCC. These findings could be used for individual risk stratification and optimization of therapeutic strategies.

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Authors’ contribution

Tobias Grimm has been in charge of the project, managing the data collection, and has written the manuscript. Alexander Buchner has been in charge of data analysis and helped editing the manuscript.Alexander Kretschmer, Markus Grabbert, Birte Schneevoigt, Maria Apfelbeck, and Friedrich Jokisch helped with data collection and have been editing the manuscript.Christian Stief and Alexander Karl were in charge of project development and were responsible for the project.

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Authors and Affiliations

  1. Department of Urology, Ludwig-Maximilians University Munich, Munich, Germany

    T. Grimm, A. Buchner, B. Schneevoigt, A. Kretschmer, M. Apfelbeck, M. Grabbert, J. F. Jokisch, C. G. Stief & A. Karl

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  1. T. Grimm
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  2. A. Buchner
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  3. B. Schneevoigt
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  4. A. Kretschmer
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  7. J. F. Jokisch
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  8. C. G. Stief
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  9. A. Karl
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Correspondence to M. Grabbert.

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Grimm, T., Buchner, A., Schneevoigt, B. et al. Impact of preoperative hemoglobin and CRP levels on cancer-specific survival in patients undergoing radical cystectomy for transitional cell carcinoma of the bladder: results of a single-center study. World J Urol 34, 703–708 (2016). https://doi.org/10.1007/s00345-015-1680-7

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  • DOI: https://doi.org/10.1007/s00345-015-1680-7

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