Using Preoperative Albumin Levels As a Surrogate Marker for Outcomes After Radical Cystectomy for Bladder Cancer
Objective To evaluate preoperative albumin levels as a marker for comparing survival outcomes after cystectomy in patients with bladder cancer. Materials and Methods We performed a retrospective record review using our bladder cancer database of 238 patients from 2004 to 2011. Of these, we included...
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| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2013-03, Vol.81 (3), p.587-592 |
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| creator | Lambert, Jack W Ingham, Matthew Gibbs, Bethany Barone Given, Robert W Lance, Raymond S Riggs, Stephen B |
| description | Objective To evaluate preoperative albumin levels as a marker for comparing survival outcomes after cystectomy in patients with bladder cancer. Materials and Methods We performed a retrospective record review using our bladder cancer database of 238 patients from 2004 to 2011. Of these, we included 187 patients with sufficient data for analysis, aged 35 years or older, who survived to undergo cystectomy. Serum albumin levels were routinely checked the day before cystectomy. Overall survival and cancer-specific survival by albumin levels were compared using Kaplan-Meier and Cox proportional hazards regression models. Complication rates between albumin groups were compared by a 2-sample test of proportions. Results Thirty-one patients (16.5%) were in the low-albumin cohort (defined as albumin |
| doi_str_mv | 10.1016/j.urology.2012.10.055 |
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Materials and Methods We performed a retrospective record review using our bladder cancer database of 238 patients from 2004 to 2011. Of these, we included 187 patients with sufficient data for analysis, aged 35 years or older, who survived to undergo cystectomy. Serum albumin levels were routinely checked the day before cystectomy. Overall survival and cancer-specific survival by albumin levels were compared using Kaplan-Meier and Cox proportional hazards regression models. Complication rates between albumin groups were compared by a 2-sample test of proportions. Results Thirty-one patients (16.5%) were in the low-albumin cohort (defined as albumin <3.5 g/dL), and 156 patients had albumin levels within normal reference ranges. Multivariable analysis showed overall survival at 3 years was 41% and 56% (adjusted hazard ratio, 1.76; P = .04) and cancer-specific survival was 57% and 72% (hazard ratio, 1.57; P = .22) in the low- and normal-albumin groups, respectively. Overall complication rates were significantly higher in the cohort with low albumin than in those with normal albumin (87% vs 65%; P = .014). Conclusion Our single-institution retrospective study demonstrates that patients with low preoperative albumin levels had an increased overall mortality and cancer-specific mortality risk than those with normal albumin levels. Albumin may therefore be a reflection of disease state as well as nutritional status.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/j.urology.2012.10.055</identifier><identifier>PMID: 23352372</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Biomarkers - blood ; Cystectomy ; Female ; Humans ; Male ; Medical sciences ; Nephrology. Urinary tract diseases ; Preoperative Care ; Retrospective Studies ; Serum Albumin - analysis ; Survival Rate ; Treatment Outcome ; Tumors of the urinary system ; Urinary Bladder Neoplasms - blood ; Urinary Bladder Neoplasms - mortality ; Urinary Bladder Neoplasms - surgery ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract. Prostate gland ; Urology</subject><ispartof>Urology (Ridgewood, N.J.), 2013-03, Vol.81 (3), p.587-592</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c450t-5c7dfb438044b3a61f9a5da7acf60f1e6adc7937838451218714438927dc0eb53</citedby><cites>FETCH-LOGICAL-c450t-5c7dfb438044b3a61f9a5da7acf60f1e6adc7937838451218714438927dc0eb53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.urology.2012.10.055$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27178936$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23352372$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lambert, Jack W</creatorcontrib><creatorcontrib>Ingham, Matthew</creatorcontrib><creatorcontrib>Gibbs, Bethany Barone</creatorcontrib><creatorcontrib>Given, Robert W</creatorcontrib><creatorcontrib>Lance, Raymond S</creatorcontrib><creatorcontrib>Riggs, Stephen B</creatorcontrib><title>Using Preoperative Albumin Levels As a Surrogate Marker for Outcomes After Radical Cystectomy for Bladder Cancer</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objective To evaluate preoperative albumin levels as a marker for comparing survival outcomes after cystectomy in patients with bladder cancer. Materials and Methods We performed a retrospective record review using our bladder cancer database of 238 patients from 2004 to 2011. Of these, we included 187 patients with sufficient data for analysis, aged 35 years or older, who survived to undergo cystectomy. Serum albumin levels were routinely checked the day before cystectomy. Overall survival and cancer-specific survival by albumin levels were compared using Kaplan-Meier and Cox proportional hazards regression models. Complication rates between albumin groups were compared by a 2-sample test of proportions. Results Thirty-one patients (16.5%) were in the low-albumin cohort (defined as albumin <3.5 g/dL), and 156 patients had albumin levels within normal reference ranges. Multivariable analysis showed overall survival at 3 years was 41% and 56% (adjusted hazard ratio, 1.76; P = .04) and cancer-specific survival was 57% and 72% (hazard ratio, 1.57; P = .22) in the low- and normal-albumin groups, respectively. Overall complication rates were significantly higher in the cohort with low albumin than in those with normal albumin (87% vs 65%; P = .014). Conclusion Our single-institution retrospective study demonstrates that patients with low preoperative albumin levels had an increased overall mortality and cancer-specific mortality risk than those with normal albumin levels. Albumin may therefore be a reflection of disease state as well as nutritional status.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cystectomy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Preoperative Care</subject><subject>Retrospective Studies</subject><subject>Serum Albumin - analysis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Tumors of the urinary system</subject><subject>Urinary Bladder Neoplasms - blood</subject><subject>Urinary Bladder Neoplasms - mortality</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urinary tract. Prostate gland</subject><subject>Urology</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk2P0zAQhiMEYsvCTwD5gsQlxd9OLqBS8SUVLWLZs-XYk8rdJC52Uin_HocWkLhwsjR-5vXo8RTFc4LXBBP5-rCeYujCfl5TTGiurbEQD4oVEVSVdV2Lh8UK4xqXnNbiqniS0gFjLKVUj4srypigTNFVcbxLftijrxHCEaIZ_QnQpmum3g9oByfoEtokZNDtFGPYmxHQFxPvIaI2RHQzjTb0kJF2zKVvxnlrOrSd0wh2DP38i3rXGefy9dYMFuLT4lFrugTPLud1cffh_fftp3J38_HzdrMrLRd4LIVVrm04qzDnDTOStLURzihjW4lbAtI4q2qmKlZxQSipFOGZrqlyFkMj2HXx6px7jOHHBGnUvU8Wus4MEKakCSNcEaIkz6g4ozaGlCK0-hh9b-KsCdaLbH3QF9l6kb2Us-zc9-LyxNT04P50_babgZcXwKQspo3ZgE9_OUVUVTOZubdnLuuGk4eok_WQbTkfs0jtgv_vKG_-SbCdH5bfuIcZ0iFMcci2NdGJaqxvl81YFoPkEC6lYD8BNfi1Aw</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Lambert, Jack W</creator><creator>Ingham, Matthew</creator><creator>Gibbs, Bethany Barone</creator><creator>Given, Robert W</creator><creator>Lance, Raymond S</creator><creator>Riggs, Stephen B</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>Using Preoperative Albumin Levels As a Surrogate Marker for Outcomes After Radical Cystectomy for Bladder Cancer</title><author>Lambert, Jack W ; Ingham, Matthew ; Gibbs, Bethany Barone ; Given, Robert W ; Lance, Raymond S ; Riggs, Stephen B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c450t-5c7dfb438044b3a61f9a5da7acf60f1e6adc7937838451218714438927dc0eb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cystectomy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Preoperative Care</topic><topic>Retrospective Studies</topic><topic>Serum Albumin - analysis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Tumors of the urinary system</topic><topic>Urinary Bladder Neoplasms - blood</topic><topic>Urinary Bladder Neoplasms - mortality</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urinary tract. Prostate gland</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lambert, Jack W</creatorcontrib><creatorcontrib>Ingham, Matthew</creatorcontrib><creatorcontrib>Gibbs, Bethany Barone</creatorcontrib><creatorcontrib>Given, Robert W</creatorcontrib><creatorcontrib>Lance, Raymond S</creatorcontrib><creatorcontrib>Riggs, Stephen B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lambert, Jack W</au><au>Ingham, Matthew</au><au>Gibbs, Bethany Barone</au><au>Given, Robert W</au><au>Lance, Raymond S</au><au>Riggs, Stephen B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using Preoperative Albumin Levels As a Surrogate Marker for Outcomes After Radical Cystectomy for Bladder Cancer</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>81</volume><issue>3</issue><spage>587</spage><epage>592</epage><pages>587-592</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objective To evaluate preoperative albumin levels as a marker for comparing survival outcomes after cystectomy in patients with bladder cancer. Materials and Methods We performed a retrospective record review using our bladder cancer database of 238 patients from 2004 to 2011. Of these, we included 187 patients with sufficient data for analysis, aged 35 years or older, who survived to undergo cystectomy. Serum albumin levels were routinely checked the day before cystectomy. Overall survival and cancer-specific survival by albumin levels were compared using Kaplan-Meier and Cox proportional hazards regression models. Complication rates between albumin groups were compared by a 2-sample test of proportions. Results Thirty-one patients (16.5%) were in the low-albumin cohort (defined as albumin <3.5 g/dL), and 156 patients had albumin levels within normal reference ranges. Multivariable analysis showed overall survival at 3 years was 41% and 56% (adjusted hazard ratio, 1.76; P = .04) and cancer-specific survival was 57% and 72% (hazard ratio, 1.57; P = .22) in the low- and normal-albumin groups, respectively. Overall complication rates were significantly higher in the cohort with low albumin than in those with normal albumin (87% vs 65%; P = .014). Conclusion Our single-institution retrospective study demonstrates that patients with low preoperative albumin levels had an increased overall mortality and cancer-specific mortality risk than those with normal albumin levels. Albumin may therefore be a reflection of disease state as well as nutritional status.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>23352372</pmid><doi>10.1016/j.urology.2012.10.055</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Biomarkers - blood Cystectomy Female Humans Male Medical sciences Nephrology. Urinary tract diseases Preoperative Care Retrospective Studies Serum Albumin - analysis Survival Rate Treatment Outcome Tumors of the urinary system Urinary Bladder Neoplasms - blood Urinary Bladder Neoplasms - mortality Urinary Bladder Neoplasms - surgery Urinary system involvement in other diseases. Miscellaneous Urinary tract. Prostate gland Urology |
| title | Using Preoperative Albumin Levels As a Surrogate Marker for Outcomes After Radical Cystectomy for Bladder Cancer |
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