TY - JOUR
T1 - The significance of preoperative serum sodium and hemoglobin in outcomes of upper tract urothelial carcinoma
T2 - Multi-center analysis between china and the united states
AU - Fang, Dong
AU - Singla, Nirmish
AU - Bao, Zhengqing
AU - Jafri, Syed M.
AU - Su, Xiaohong
AU - Cao, Zhenpeng
AU - Xiong, Gengyan
AU - Zhang, Lei
AU - Woldu, Solomon
AU - Hutchinson, Ryan
AU - Sagalowsky, Arthur
AU - Lotan, Yair
AU - Li, Xuesong
AU - Raman, Jay D.
AU - Margulis, Vitaly
AU - Zhou, Liqun
N1 - Funding Information:
Acknowledgments. The authors are very grateful to Dr. Ryan Pekson, Albert Einstein College of Medicine, for his valuable assistance with the preparation of some of the figures. This article is dedicated to the authors’ beloved co-author, colleague, and friend, Dr. Ellen B. Katz, who bravely worked on this manuscript in spite of her illness until the end. The authors regret that she was not able to see this work published. Funding. This work was supported by National Institutes of Health (NIH) grant R21 DK081194 (to M.J.C.), American Diabetes Association grant 1-13-CE-06 (to M.J.C.), and an NIH Ruth Kirschstein predoctoral fellowship (F31 DK093332 [to L.W.]). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. M.J.C. conceived the idea of the project, supervised all of the experiments, revised the figures, edited the manuscript, and provided funding. L.W. performed the experiments and produced the first draft of the manuscript. Y.S., X.Q.D., B.C., A.S., S.A.S., and E.B.K. provided intellectual input into the design of the project and assisted with some experiments. P.M.V. provided intellectual input into the design of the project and edited the manuscript. S.E.R. evaluated the data, interpreted the histopathology, and revised the manuscript. M.J.C. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Publisher Copyright:
© 2020, Dove Medical Press Ltd.. All rights reserved.
PY - 2020
Y1 - 2020
N2 - Purpose: To analyze the effect of preoperative serum sodium and hemoglobin on oncologic outcomes in upper tract urothelial carcinoma (UTUC) based on a multi-center cohort from China and the United States (U.S.). Methods: We retrospectively reviewed the records of 775 patients with UTUC treated surgically at tertiary care medical facilities in China or the US from 1998 to 2015. We analyzed associations of preoperative serum sodium and hemoglobin with clinicopathological characteristics, overall survival (OS), cancer-specific survival (CSS) and intravesical recurrence free survival (IVRFS). Results: The US patients had comparatively lower serum sodium and similar hemoglobin at baseline. Preoperative low serum sodium value was associated with tumor multifocality, lymph node metastasis (LNM) and lymphovascular invasion (LVI); preoperative anemia was associated with advanced age, tumor multifocality, high tumor grade and LVI. Preoperative low serum sodium was an independent predictor of worse OS in the entire cohort; preoperative anemia was an independent predictor of worse OS and CSS in the US cohort alone, Chinese cohort alone and the combined cohort. We developed a predictive nomogram for OS which exhibited better prognostic value when it included the values of sodium and anemia, and successfully validated it in different cohorts. Conclusion: Preoperative low serum sodium and anemia could be informative in predicting worse pathologic and survival outcomes in different UTUC patient ethnic groups.
AB - Purpose: To analyze the effect of preoperative serum sodium and hemoglobin on oncologic outcomes in upper tract urothelial carcinoma (UTUC) based on a multi-center cohort from China and the United States (U.S.). Methods: We retrospectively reviewed the records of 775 patients with UTUC treated surgically at tertiary care medical facilities in China or the US from 1998 to 2015. We analyzed associations of preoperative serum sodium and hemoglobin with clinicopathological characteristics, overall survival (OS), cancer-specific survival (CSS) and intravesical recurrence free survival (IVRFS). Results: The US patients had comparatively lower serum sodium and similar hemoglobin at baseline. Preoperative low serum sodium value was associated with tumor multifocality, lymph node metastasis (LNM) and lymphovascular invasion (LVI); preoperative anemia was associated with advanced age, tumor multifocality, high tumor grade and LVI. Preoperative low serum sodium was an independent predictor of worse OS in the entire cohort; preoperative anemia was an independent predictor of worse OS and CSS in the US cohort alone, Chinese cohort alone and the combined cohort. We developed a predictive nomogram for OS which exhibited better prognostic value when it included the values of sodium and anemia, and successfully validated it in different cohorts. Conclusion: Preoperative low serum sodium and anemia could be informative in predicting worse pathologic and survival outcomes in different UTUC patient ethnic groups.
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U2 - 10.2147/CMAR.S267969
DO - 10.2147/CMAR.S267969
M3 - Article
C2 - 33116841
AN - SCOPUS:85092790183
SN - 1179-1322
VL - 12
SP - 9825
EP - 9836
JO - Cancer Management and Research
JF - Cancer Management and Research
ER -
