Preoperative low plasma creatine kinase levels predict worse survival outcomes in bladder cancer after radical cystectomy.

Yifan Li, Hang Xu, Tianhai Lin, Jiapeng Zhang, Jianzhong Ai, Shiyu Zhang, Weizhen Le, Ping Tan, Peng Zhang, Qiang Wei, Xiaonan Zheng, Lu Yang
Author Information
  1. Yifan Li: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  2. Hang Xu: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  3. Tianhai Lin: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  4. Jiapeng Zhang: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  5. Jianzhong Ai: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  6. Shiyu Zhang: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  7. Weizhen Le: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  8. Ping Tan: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  9. Peng Zhang: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  10. Qiang Wei: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
  11. Xiaonan Zheng: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China. xiaonan.zheng@scu.edu.cn.
  12. Lu Yang: Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China. wycleflue@163.com. ORCID

Abstract

BACKGROUND AND AIMS: To evaluate the prognostic significance of preoperative creatine kinase (CK) levels in bladder cancer (BCa) patients who underwent radical cystectomy (RC).
MATERIALS AND METHODS: 570 BCa patients with RC were identified between 2010 and 2020. 108.5 U/L of CK levels were defined as the cutoff value. Logistic regression analysis and Cox regression models were performed to evaluate the association between CK levels and oncologic outcomes. Subgroup analyses were performed to address cofounding factors.
RESULTS: Preoperative low CK levels were associated with worse recurrence-free survival (RFS, log-rank P = 0.001) and overall survival (OS, log-rank P = 0.002). Multivariate analysis revealed that preoperative low CK levels were an independent predictor for worse RFS (hazard ratio [HR]: 1.683; P < 0.001) and OS (HR: 1.567; P = 0.002).
CONCLUSIONS: The preoperative low CK level independently predicts worse survival outcomes in BCa after RC. Incorporating it into prediction models might be valuable to assist risk stratification.

Keywords

References

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Grants

  1. 82070784/National Natural Science Foundation of China
  2. 81702536/National Natural Science Foundation of China
  3. 81974099/National Natural Science Foundation of China
  4. 82170785/National Natural Science Foundation of China
  5. 2022JDRC0040/Science & Technology Department of Sichuan Province, China
  6. 21GJHZ0246/Science and Technology Department of Sichuan Province
  7. 2017SCU04A17/Young Investigator Award of Sichuan University 2017
  8. 2020CDPZH-4/Sichuan University--Panzhihua science and technology cooperation special fund
  9. 2021M692306/China Postdoctoral Science Foundation
  10. 2021HXBH025/Post-Doctor Research Project of West China Hospital of Sichuan University

MeSH Term

Humans
Urinary Bladder Neoplasms
Cystectomy
Female
Male
Aged
Middle Aged
Creatine Kinase
Preoperative Period
Retrospective Studies
Survival Rate
Prognosis
Predictive Value of Tests

Chemicals

Creatine Kinase

Word Cloud

Created with Highcharts 10.0.0CKlevelslowworsesurvivalpreoperativekinasecancerBCacystectomyRCoutcomesP = 0ANDevaluatecreatinebladderpatientsradicalregressionanalysismodelsperformedPreoperativeRFSlog-rank001OS0021BACKGROUNDAIMS:prognosticsignificanceunderwentMATERIALSMETHODS:570identified201020201085 U/LdefinedcutoffvalueLogisticCoxassociationoncologicSubgroupanalysesaddresscofoundingfactorsRESULTS:associatedrecurrence-freeoverallMultivariaterevealedindependentpredictorhazardratio[HR]:683P < 0HR:567CONCLUSIONS:levelindependentlypredictsIncorporatingpredictionmightvaluableassistriskstratificationplasmapredictBladderCreatinePrognosisRadical

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