Presentation Authors: Friedrich Jokisch*, Munich , Germany, Tobias Grimm, Munich, Germany, Alexander Buchner, Gerald Schulz, Alexander Kretschmer, Munich , Germany, Alexander Karl, Christian Stief, Munich, Germany
Introduction: For many solid and malignant tumours thrombocytosis is associated with an impaired onclogical outcome concerning cancer specific survival (CSS)._x000D_
So far there is only limited data on the prognostic relevance in patients undergoing radical cystectomy (RC) for urothelial carcinoma of the bladder (UC). _x000D_
The aim of this study was to investigate the influence of an elevated platelet count (PPC) in patients undergoing RC for UC on the oncological prognosis in a large cohort of patients. Furthermore, correlation of preoperative thrombocytosis (PTC) with histo-pathological parameters and perioperative blood transfusion (PBT) rates were analyzed.
Methods: A retrospective analysis of 866 patients undergoing RC for UC between 2004 and 2017 in a tertiary care urological department was performed. For the cohort PTC was defined as a platelet count > 400 G/l. Chi-square test and Mann-Whitney test were used to investigate the association of PTC with categorical variables (tumour stage, grade and perioperative BT parameters). Logrank test and Cox regression analyses were used to analyse the association of PTC with outcome.
Results: The median age of patients at the moment of RC was 70 years, 23% were female and 77% were male. The median PPC in the cohort was 255 G/l. PTC was detected in 8% of the patients. The median follow-up was 23 months. The CSS adapted to PTC (thrombocytes: < 400 G/l vs. > 400 G/l) was 70% vs. 44% after 2 years and 55% vs. 29% after 5 years, respectively. PTC was significantly associated with muscle invasion, advanced tumour stages and nodal metastases. PTC was also significantly associated with a higher rate of PBT (52% (35/67) vs. 31% (250/799); p= < 0.001). In the multivariate analysis PTC was significantly related to poor oncological survival (Hazard Ratio=2.23; p < 0.001).
Conclusions: In this study, PTC was significantly associated with impaired oncological outcome of patients undergoing RC for UC. It represents an independent prognostic parameter for patients' oncological outcome after RC and therefore can help to identify patients with poor prognosis. Intriguingly, PTC is significantly correlated to an increased rate of PBT, which can be explained through tumour-associated alterations of haemostasis.