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Preoperative plasma level of endoglin as a predictor for disease outcomes after radical cystectomy for nonmetastatic urothelial carcinoma of the bladder
E. Laukhtina, VM. Schuettfort, D. D'Andrea, B. Pradere, K. Mori, F. Quhal, R. Sari Motlagh, H. Mostafaei, S. Katayama, NС. Grossmann, P. Rajwa, F. Zeinler, M. Abufaraj, M. Moschini, K. Zimmermann, PI. Karakiewicz, H. Fajkovic, D. Scherr, E....
Language English Country United States
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
34587660
DOI
10.1002/mc.23355
Knihovny.cz E-resources
- MeSH
- Survival Analysis MeSH
- Cystectomy MeSH
- Endoglin blood MeSH
- Carcinoma, Transitional Cell blood pathology surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Lymph Node Excision MeSH
- Biomarkers, Tumor blood MeSH
- Urinary Bladder Neoplasms blood pathology surgery MeSH
- Preoperative Period MeSH
- Prognosis MeSH
- Prospective Studies MeSH
- Gene Expression Regulation, Neoplastic MeSH
- Aged MeSH
- Neoplasm Staging MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Elevated preoperative plasma level of endoglin has been associated with worse oncologic outcomes in various malignancies. The present large-scale study aimed to determine the predictive and prognostic values of preoperative endoglin with regard to clinicopathologic and survival outcomes in patients treated with radical cystectomy (RC) for nonmetastatic urothelial carcinoma of the bladder (UCB). We prospectively collected preoperative blood samples from 1036 consecutive patients treated with RC for UCB. Logistic and Cox regression analyses were undertaken to assess the correlation of endoglin levels with pathologic and survival outcomes, respectively. The AUC and C-index were used to assess the discrimination. Patients with adverse pathologic features had significantly higher median preoperative endoglin plasma levels than their counterparts. Higher preoperative endoglin level was independently associated with an increased risk for lymph node metastasis, ≥pT3 disease, and nonorgan confined disease (NOCD; all p < 0.001). Plasma endoglin level was also independently associated with cancer-specific and overall survival in both pre- and postoperative models (all p < 0.05), as well as with recurrence-free survival (RFS) in the preoperative model (p < 0.001). The addition of endoglin to the preoperative standard model improved its discrimination for prediction of lymph node metastasis, ≥pT3 disease, NOCD, and RFS (differential increases in C-indices: 10%, 5%, 5.8%, and 4%, respectively). Preoperative plasma endoglin is associated with features of biologically and clinically aggressive UCB as well as survival outcomes. Therefore, it seems to hold the potential of identifying UCB patients who may benefit from intensified therapy in addition to RC such as extended lymphadenectomy or/and preoperative systemic therapy.
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Federal Armed Services Hospital Koblenz Koblenz Germany
Department of Urology King Fahad Specialist Hospital Dammam Saudi Arabia
Department of Urology Luzerner Kantonsspital Lucerne Switzerland
Department of Urology Medical University of Silesia Zabrze Poland
Department of Urology Semmelweis University Budapest Hungary
Department of Urology The Jikei University School of Medicine Tokyo Japan
Department of Urology University Hospital Zurich Zurich Switzerland
Department of Urology University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Urology University of Texas Southwestern Dallas Texas USA
Department of Urology Weill Cornell Medical College New York New York USA
Hourani Center for Applied Scientific Research Al Ahliyya Amman University Amman Jordan
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Research Center for Evidence Based Medicine Tabriz University of Medical Sciences Tabriz Iran
References provided by Crossref.org
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