The significance of preoperative estimated glomerular filtration rate on survival outcomes in patients who underwent radical cystectomy and non-continent urinary diversion

术前估算肾小球滤过率对接受根治性膀胱切除术和非控尿性尿流改道患者生存结局的影响

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Abstract

PURPOSE: To evaluate the influence of preoperative renal function on survival outcomes in patients who underwent radical cystectomy (RC) with non-continent urinary diversion (UD). MATERIALS AND METHODS: A total of 132 patients with bladder cancer who underwent RC with non-continent UD due to urothelial carcinoma from January 2006 toMarch 2017 at our tertiary referral center were retrospectively evaluated. Patients were divided into 2 groups as those with estimated glomerular filtration rate (eGFR)<60mL/min/1.73 m2 and ≥60mL/min/1.73 m2 according to preoperative eGFR levels. Patients' characteristics, preoperative clinical data, operative data, pathologic data, oncologic data and complications were compared between the groups. RESULTS: The mean age was 64.5±8.7 (range: 32 - 83) years and the median follow-up was 30.9±31.7 (range: 1-113) months. There were 46 patients in Group 1 and 86 patients in Group 2. There was no difference in cancer-specific mortality (45.6% for group 1 and 30.2% for group 2, p=0.078) and survival (56.8±8.3 months for group 1 and 70.5±5.9 months for group 2, p=0.087) between the groups. Overall mortality was higher (63% for group 1 and 40.7% for group 2, p=0.014) and overall survival (43.6±6.9 months for group 1 and 62.2±5.8 months for group 2, p=0.03) was lower in Group 1 compared to Group 2. CONCLUSIONS: Overall mortality was higher and overall survival was lower in patients with preoperative eGFR<60mL/s. More patients had preoperative hydronephrosis with eGFR<60mL/s.

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