Üst Ürı̇ner Sı̇stem Ürotelyal Kanserı̇ Nedenı̇yle Cerrahı̇ Yapılan Hastalarda Prognoz Ve Mesane Rekürrensı̇ Üzerine Etkili Faktörlerin Araştırılması

Abstract

Altan M. Evaluation Of The Factors That Effect The Prognosis And Bladder Recurrences Of The Patients Who Had Surgery For Upper Urinary Tract Urothelial Carcinoma. University of Hacettepe School of Medicine, Thesis in Urology, Ankara 2016. Data of 140 patients, who had surgery for primary upper urinary tract urothelial carcinoma (UUT UC) without metastasis and/or invasive bladder carcinoma (BC) at the time of diagnosis from 1990 to 2015 analysed retrospectively. Factors affecting the bladder carcinoma recurrence and survival rates were evaluated. Statistical analyses was done with SPSS 23.0 statistic programme. Median follow up and mean age were 45 (3-324) months and 62.5±11.6 years, respectively. Male to female ratio was 110/30. Previous BC history and high grade UUT UC tumor history were independent risk factors for BC recurrence (p=0.006 and p=0.002; respectively). High tumor stage (≥T1), presence of anemia, high grade and positive surgical margin status were found to be independent risk factors for cancer specific survival (p=0.035, p=0.001, p=0.039, p<0.001; respectively). The effect of neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR) and platelet/lymphocyte (PLR) ratios’ on survival was evaluated on 113 patients who had complete data. Cut-off values of NLR, LMR, PLR were calculated for recurrence free UUT UC survival, BC recurrence was excluded (2.89 (<2.9 and ≥2.9), 2.88 (<2.9 and ≥2.9), 149.4 (<150 and ≥150), respectively). High NLR is found to be an independent risk factor for recurrence free, cancer specific and disease free survival. Lower LMR value was an independent risk factor for recurrence free and cancer specific survival rates. Higher tumor stage and grades, presence of anemia, positive surgical margin were important risk factors for cancer specific survival. Patients with previous BC history or high grade UUT UC tumors must be followed more vigilantly since increased risk of bladder recurrences. NLR and LMR are independent preoperative prognostic risk factors for survival and recurrence.