Annals of Surgical Oncology

, Volume 24, Issue 3, pp 823–831

Prognostic Impact of Renin-Angiotensin Inhibitors in Patients with Bladder Cancer Undergoing Radical Cystectomy

  • Takashi Yoshida
  • Hidefumi Kinoshita
  • Katsuya Fukui
  • Tomoaki Matsuzaki
  • Kenji Yoshida
  • Takao Mishima
  • Masaaki Yanishi
  • Yoshihiro Komai
  • Motohiko Sugi
  • Takaaki Inoue
  • Takashi Murota
  • Tadashi Matsuda
Urologic Oncology

DOI: 10.1245/s10434-016-5534-3

Cite this article as:
Yoshida, T., Kinoshita, H., Fukui, K. et al. Ann Surg Oncol (2017) 24: 823. doi:10.1245/s10434-016-5534-3
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Abstract

Background

Renin-angiotensin system blockade has been effective for the treatment of patients with several types of malignancy. This study evaluated the prognostic impact of renin-angiotensin system inhibitors, including angiotensin-2 converting enzyme inhibitors and angiotensin 2 receptor blockers, in patients with bladder cancer undergoing radical cystectomy.

Methods

This retrospective study included 269 patients who had undergone radical cystectomy. The oncologic outcomes of patients treated or not treated with renin-angiotensin system inhibitors after surgery were evaluated. Overall survival and cancer-specific survival were assessed by the Kaplan–Meier method and by Cox regression analysis.

Results

The median follow-up duration after radical cystectomy in survivors was 44.5 months. The 5-year, cancer-specific survival rates in patients who did and did not receive renin-angiotensin system inhibitors were 79.0 and 66.4 %, respectively (P = 0.011). Similarly, the 5-year overall survival rates were 76.1 and 61.4 %, respectively (P = 0.0097). Multivariable analyses showed that use of renin-angiotensin system inhibitors was an independent prognostic factor for cancer-specific survival (hazard ratio 0.47, P = 0.036) and for overall survival (hazard ratio 0.36, P = 0.022).

Conclusions

Renin-angiotensin system inhibitors significantly reduced the risks of cancer-specific and overall mortality after radical cystectomy in patients with bladder cancer. Renin-angiotensin system inhibitors may improve oncologic outcomes in high-risk patients with bladder cancer.

Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Takashi Yoshida
    • 1
    • 2
  • Hidefumi Kinoshita
    • 2
  • Katsuya Fukui
    • 1
  • Tomoaki Matsuzaki
    • 3
  • Kenji Yoshida
    • 2
  • Takao Mishima
    • 2
  • Masaaki Yanishi
    • 2
  • Yoshihiro Komai
    • 2
  • Motohiko Sugi
    • 2
  • Takaaki Inoue
    • 3
  • Takashi Murota
    • 3
  • Tadashi Matsuda
    • 2
  1. 1.Department of Urology and AndrologyKansai Medical University, Kori HospitalOsakaJapan
  2. 2.Department of Urology and AndrologyKansai Medical University HospitalOsakaJapan
  3. 3.Department of Urology and AndrologyKansai Medical University, General Medical CenterOsakaJapan