A risk-group classification model in patients with bladder cancer under neoadjuvant cisplatin-based combination chemotherapy

Author:

Ferro Matteo1,Lucarelli Giuseppe2,de Cobelli Ottavio1,Dolce Pasquale3,Terracciano Daniela4ORCID,Musi Gennaro1,Porreca Angelo5,Busetto Gian Maria6,Del Giudice Francesco6,Soria Francesco7,Gontero Paolo7,Cantiello Francesco8,Damiano Rocco8,Crocerossa Fabio8,Abu Farhan Abdal Rahman8,Autorino Riccardo9,Vartolomei Mihai Dorin1011,Marchioni Michele12,Mari Andrea13,Minervini Andrea13,Longo Nicola14,Celentano Giuseppe14,Chiancone Francesco15ORCID,Perdonà Sisto16,Del Prete Paola17,Ditonno Pasquale2,Battaglia Michele2,Zamboni Stefania18,Antonelli Alessandro1819,Greco Francesco20,Russo Giorgio Ivan21,Hurle Rodolfo22,Crisan Nicolae23,Manfredi Matteo24,Porpiglia Francesco24,Ribera Dario25,De Placido Pietro25,Facchini Sergio26ORCID,Scafuri Luca25,Verde Antonio25,Di Lorenzo Giuseppe2728,Cosimato Vincenzo29,Luciano Angelo25,Caputo Vincenzo Francesco14,Crocetto Felice14,Buonerba Carlo3031

Affiliation:

1. Division of Urology, European Institute of Oncology, IRCCS, Milan 80131, Italy

2. Department of Emergency & Organ Transplantation—Urology, Andrology & Kidney Transplantation Unit, University of Bari, Bari 70124, Italy

3. Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples 80131, Italy

4. Department of Translational Medical Sciences, University Federico II, Naples, Italy

5. Department of Urology, Abano Terme Hospital, Padua 35031, Italy

6. Department of Urology, Sapienza University of Rome, Rome 00185, Italy

7. Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin 10121, Italy

8. Department of Urology, Magna Graecia University of Catanzaro, Catanzaro 88100, Italy

9. Division of Urology, VCU Health System, Virginia Commonwealth University, Richmond, VA 23219, USA

10. Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18–20, Vienna 1090, Austria

11. Department of Cell & Molecular Biology, University of Medicine, Pharmacy, Sciences & Technology, Targu Mures 540139, Romania

12. Department of Medical, Oral & Biotechnological Sciences, G. d'Annunzio University of Chieti, Chieti, Italy

13. Department of Urology, University of Florence, Careggi Hospital, Florence, Italy

14. Department of Neurosciences, Human Reproduction & Odontostomatology, University of Naples Federico II, Naples, Italy

15. Urology Unit, AORN A. Cardarelli, Naples, Italy

16. Division of Urology, Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale,” Naples, Italy

17. Scientific Directorate, Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale,” Naples, Italy

18. Department of Urology, Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, Italy

19. Department of Urology, University of Verona, Verona, Italy

20. Department of Urology, Humanitas Gavazzeni, Bergamo, Italy

21. Department of Urology, University of Catania, Catania, Italy

22. Department of Urology, Humanitas Hospital, Milan, Italy

23. Department of Urology, University of Medicine & Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania

24. Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy

25. Department of Clinical Medicine & Surgery, University Federico II of Naples, Via Pansini 5, Naples 80131, Italy

26. Medical Oncology, Department of Precision Medicine, School of Medicine, “Luigi Vanvitelli” University of Campania, Naples 80131, Italy

27. Oncology Unit, Andrea Tortora Hospital, ASL Salerno, Pagani, Italy

28. Vincenzo Tiberio, Department of Medicine & Health Sciences, University of Molise, Campobasso, Italy

29. Division of Onco-hematology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy

30. Regional Reference Center for Rare Tumors, Department of Oncology & Hematology, AOU Federico II of Naples, Naples 80131, Italy

31. Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy

Abstract

The objective of the current research was to explore the potential prognostic value of readily available clinical and pathologic variables in bladder cancer. The novel association found between cholesterol levels and prognosis may provide the rationale for exploring novel treatments. Patients included had histologically confirmed urothelial bladder cancer and were treated with at least 3 cycles of cisplatin-based neoadjuvant chemotherapy before radical cystectomy with lymphadenectomy. A total of 245 patients at low, intermediate and high risk, presenting with 0–1, 2 or 3–4 risk factors, including positive lymph nodes, Hb <12.8, NLR ≥2.7 and cholesterol levels ≥199, were included. Five-year cancer-specific survival rate was 0.67, 0.78 and 0.94 at high, intermediate and low risk, respectively. Total cholesterol levels at the time of cystectomy may represent a commonly assessable prognostic factor and may be incorporated in a clinically meaningful risk-group classification model.

Publisher

Future Medicine Ltd

Subject

Cancer Research,Oncology,General Medicine

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