机构：[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.四川大学华西医院[2]Department of Emergency, West China Hospital, Sichuan University, Chengdu, Sichuan, China.四川大学华西医院[3]Department of Liver Surgery, Liver Transplantation Division, West China Hospital, Sichuan University, Chengdu, Sichuan, China.四川大学华西医院[4]Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.四川大学华西医院
The aim of this study was to investigate the effect of preoperative anemia on the prognosis of patients who underwent radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).A total of 620 patients with UTUC were retrospectively analyzed. Anemia was decided by preoperatively measured hemoglobin values based on the World Health Organization (WHO) classification. Kaplan-Meier method and Cox proportional hazards regression models were used to analyze the relationship between anemia and survival outcomes. The meta-analysis part was performed according to PRISMA guidelines.The median follow-up was 51 (range: 1-168) months. A total of 246 patients had preoperative anemia in our cohort. Anemia was found to be related to high-grade (P < .001), sessile architecture (P = .001), advanced T stage (P < .001), lymphovascular invasion (LVI) (P = .006), and worse chronic kidney disease (CKD) stage (P = .012). Kaplan-Meier curves revealed that patients with preoperative anemia had worse overall survival (OS), cancer-specific survival (CSS), and disease recurrence-free survival (RFS) (all P < .001). Multivariable Cox analyses found that anemia was an independent predictor of CSS [hazard ratio (HR) 1.719, 95% confidence interval (95% CI): 1.285-2.300], RFS (HR 1.427, 95% CI: 1.114-1.829) and OS (HR 1.756, 95% CI: 1.353-2.279). Among patients without end-stage renal disease (ESRD, n = 614), the anemia was also proved to be associated with worse outcomes in multivariable Cox analysis (OS, HR 1.759, 95% CI: 1.353-2.287; CSS, HR 1.726, 95% CI: 1.289-2.311, and RFS, HR 1.431, 95% CI: 1.117-1.837). Seven studies were included in the meta-analysis, and the pooled results showed that anemia was also related to worse CSS (HR 2.05, 95% CI: 1.73-2.44), RFS (HR 1.57, 95% CI: 1.30-1.90), and OS (HR 1.53, 95% CI: 1.10-2.13), but not related to intravesical recurrence (HR 1.17, 95% CI: 0.75-1.82).Preoperative anemia was proved to be significantly associated with worse oncologic outcomes in patients with UTUC following RNU.
基金：
National key research and development program of China (Grant No. SQ2017YFSF090096), the Prostate Cancer
Foundation Young Investigator Award 2013, the National Natural Science Foundation of China (Grant No. 81300627, 81370855, 81702536, 81770756), Fundings from
Science and Technology Department of Sichuan Province (Grant No. 2014JY0219 and 2017HH0063), and Young Investigator Award of Sichuan University 2017
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2018]版：
大类|4 区医学
小类|3 区医学：内科
最新[2023]版：
大类|4 区医学
小类|4 区医学：内科
第一作者：
第一作者机构：[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.[*1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Number 37, Guoxue Alley, Chengdu, Sichuan 610041, China
推荐引用方式(GB/T 7714)：
Tan Ping,Xie Nan,Liao Haotian,et al.Prognostic impact of preoperative anemia on upper tract urothelial carcinoma.[J].Medicine.2018,97(37):e12300.doi:10.1097/MD.0000000000012300.
APA：
Tan Ping,Xie Nan,Liao Haotian,Zou Liqun,Xu Huan...&Wei Qiang.(2018).Prognostic impact of preoperative anemia on upper tract urothelial carcinoma..Medicine,97,(37)
MLA：
Tan Ping,et al."Prognostic impact of preoperative anemia on upper tract urothelial carcinoma.".Medicine 97..37(2018):e12300
