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The prognostic role of pre-cystectomy thrombocytosis in invasive bladder cancer

  • Urology - Original Paper
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Abstract

Purpose

We aim to evaluate the impact of preoperative thrombocytosis on oncological outcomes in patients with bladder cancer (BC) who undergo radical cystectomy (RC).

Methods

Retrospective data collection of 1092 patients managed by RC for BC from 2 tertiary-care centers was performed. Elevated platelet count (PLT) was defined as > 450 × 109/L. Univariable and multivariable logistic regression analyses were used to investigate the impact of thrombocytosis on oncological outcomes. These outcomes were also compared using Kaplan–Meier survival analysis.

Results

The median follow-up was 50 months (32–64 months). Thrombocytosis was detected in 18.6% of the patients. The 3-year cancer-specific survival (CSS) for patients with normal PLT count was 92% which was higher than those with elevated PLT count (55%, P < 0.001). Similar results were found for the 6-year CSS with 82% for the no thrombocytosis group and 27% for the thrombocytosis group. Thrombocytosis was still significantly associated with poor prognosis for overall survival and recurrence-free survival (P < 0.001). In the multivariate analysis, CSS was significantly lower in patients with thrombocytosis (HR = 1.71, 95% CI = 1.22–2.39, P = 0.002). Patients with elevated PLT counts were also significantly more likely to receive adjuvant chemotherapy, to have a T stage > pT2b (P = 0.024), to have a positive lymph node, to have variant histology and positive resection margins, and to have concomitant carcinoma in situ (CIS) on final pathology (all P < 0.001).

Conclusions

Preoperative thrombocytosis was valuable for predicting the oncological outcomes of patients undergoing RC for BC.

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Authors and Affiliations

  1. Department of Urology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 75013, Paris, France

    Mohamad Abou Chakra, David Azoulai, Michael Peyromaure, Nicolas Barry Delongchamps, Djillali Saighi, Hugo Bailly & Igor Duquesne

  2. Department of Urology, Lebanese University, Beirut, Lebanon

    Mohamad Abou Chakra

  3. Surgery and Urology Department, Lebanese University, Beirut, Lebanon

    Mohamad Moussa

  4. Epidemiology and Statistic Department, Lebanese University, Beirut, Lebanon

    Khadija Ismail

Authors
  1. Mohamad Abou Chakra
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  2. David Azoulai
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  3. Mohamad Moussa
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  4. Khadija Ismail
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Correspondence to Mohamad Abou Chakra.

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Chakra, M.A., Azoulai, D., Moussa, M. et al. The prognostic role of pre-cystectomy thrombocytosis in invasive bladder cancer. Int Urol Nephrol 54, 3153–3161 (2022). https://doi.org/10.1007/s11255-022-03346-7

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  • DOI: https://doi.org/10.1007/s11255-022-03346-7

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