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International Journal of Clinical Oncology

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01-05-2019 | Sarcopenia | Original Article

Preoperative predictive factors focused on inflammation-, nutrition-, and muscle-status in patients with upper urinary tract urothelial carcinoma undergoing nephroureterectomy

Authors: Yoshitaka Itami, Makito Miyake, Yoshihiro Tatsumi, Daisuke Gotoh, Shunta Hori, Yousuke Morizawa, Kota Iida, Kenta Ohnishi, Yasushi Nakai, Takeshi Inoue, Satoshi Anai, Nobumichi Tanaka, Keiji Shimada, Shuya Hirao, Kiyohide Fujimoto

Published in: International Journal of Clinical Oncology | Issue 5/2019

Abstract

Objective

The present study evaluated the clinical relevance of an integrative preoperative assessment of inflammation-, nutrition-, and muscle-based markers for patients with upper urinary tract urothelial carcinoma (UTUC) undergoing curative nephroureterectomy (NUx).

Methods

The study enrolled 125 patients and the preoperative variables assessed included age, body mass index, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), serum fibrinogen level (Fib), C-reactive protein (CRP), modified Glasgow prognostic score, serum albumin level (Alb), prognostic nutritional index (PNI), skeletal muscle index (SMI), psoas muscle index (PMI), and peak expiratory flow (PEF). The correlations among the variables and their prognostic values after NUx were evaluated.

Results

Five inflammation markers (NLR, MLR, PLR, Fib and CRP) were positively correlated. Fib was positively correlated with NLR, PLR and CRP, but inversely correlated with SMI. PNI was inversely correlated with age and the four inflammation markers (p < 0.001). Age was not significantly correlated with the inflammation markers, but older age was associated with lower Alb, PNI, SMI, PMI, and PEF. Disease-specific survival was independently predicted by preoperative ipsilateral hydronephrosis and low PNI. Overall survival was independently associated with high Fib and low PNI.

Conclusion

The preoperative inflammation-, nutrition-, and muscle-based markers would be useful risk assessment tools for UTUC.

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Title: Preoperative predictive factors focused on inflammation-, nutrition-, and muscle-status in patients with upper urinary tract urothelial carcinoma undergoing nephroureterectomy
Authors: Yoshitaka Itami
Makito Miyake
Yoshihiro Tatsumi
Daisuke Gotoh
Shunta Hori
Yousuke Morizawa
Kota Iida
Kenta Ohnishi
Yasushi Nakai
Takeshi Inoue
Satoshi Anai
Nobumichi Tanaka
Keiji Shimada
Shuya Hirao
Kiyohide Fujimoto
Publication date: 01-05-2019
Publisher: Springer Singapore
Keywords: Sarcopenia
Nutrition
Urothelial Cancer
Urothelial Cancer
Published in: International Journal of Clinical Oncology / Issue 5/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-018-01381-y

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Abstract

Objective

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