Fang Dong, Singla Nirmish, Bao Zhengqing, Jafri Syed M, Su Xiaohong, Cao Zhenpeng, Xiong Gengyan, Zhang Lei, Woldu Solomon, Hutchinson Ryan, Sagalowsky Arthur, Lotan Yair, Li Xuesong, Raman Jay D, Margulis Vitaly, Zhou Liqun
Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People's Republic of China.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Cancer Manag Res. 2020 Oct 8;12:9825-9836. doi: 10.2147/CMAR.S267969. eCollection 2020.
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.).
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).
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.
Preoperative low serum sodium and anemia could be informative in predicting worse pathologic and survival outcomes in different UTUC patient ethnic groups.
基于来自中国和美国的多中心队列，分析术前血清钠和血红蛋白对上尿路尿路上皮癌（UTUC）肿瘤学结局的影响。
我们回顾性分析了1998年至2015年在中国或美国三级医疗设施接受手术治疗的775例UTUC患者的记录。我们分析了术前血清钠和血红蛋白与临床病理特征、总生存期（OS）、癌症特异性生存期（CSS）和膀胱内无复发生存期（IVRFS）之间的关联。
美国患者基线时血清钠相对较低，血红蛋白相似。术前低血清钠值与肿瘤多灶性、淋巴结转移（LNM）和淋巴管浸润（LVI）相关；术前贫血与高龄、肿瘤多灶性、高肿瘤分级和LVI相关。术前低血清钠是整个队列中OS较差的独立预测因素；术前贫血仅是美国队列、中国队列及合并队列中OS和CSS较差的独立预测因素。我们开发了一种OS预测列线图，当纳入钠和贫血值时，其显示出更好的预后价值，并在不同队列中成功验证。
术前低血清钠和贫血可能有助于预测不同UTUC患者种族中较差的病理和生存结局。
