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January 1, 2022Investigative and Clinical Urology13 citationsOpen Access

Prognostic value of the endothelial activation and stress index in patients with upper tract urothelial cancer undergoing radical nephroureterectomy

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JGJin Seok GuJRJi Won RyuSYSeong Hyeon Yu

Key Result

A high endothelial activation and stress index score was independently associated with worse recurrence-free survival (HR 1.68) and overall survival (HR 1.71) in upper tract urothelial carcinoma.

Study Design

Type

Cohort (n=380)

Multicenter

Yes

Structured PICO

Does a high EASIX score predict worse recurrence-free and overall survival in patients with UTUC undergoing radical nephroureterectomy?

P
Population
Patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU)
I
Intervention
High endothelial activation and stress index (EASIX) score (>1.27)
C
Comparator
Low EASIX score (≤1.27)
O
Outcome
Recurrence-free survival (RFS) and overall survival (OS)hard clinical

A high EASIX score is a significant prognostic factor for worse recurrence-free and overall survival in patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy.

Main Result

Effect estimate: HR 1.68 (95% CI 1.22-2.30)

Absolute Event Rate: 13% vs 23.4%

p-value: p=0.001

Limitations

  • Retrospective multicenter design with possible variations in laboratory, pathologic, and surgical assessments
  • Lack of data on pathologic lymph node status
  • Hematologic factors used in the EASIX score can be affected by underlying diseases other than malignancy
  • Only preoperative laboratory values were assessed
  • A definite cutoff value for the EASIX score needs to be established

Abstract

PURPOSE: The relationship with endothelial activation and stress index (EASIX), which represents the degree of endothelial dysfunction, is unwell known in upper tract urothelial carcinoma (UTUC). The present study aims to assess the prognostic value of the EASIX for recurrence-free survival (RFS) and overall survival (OS) in patients with UTUC who underwent radical nephroureterectomy (RNU). MATERIALS AND METHODS: -transformed values. We divided the patients according to the EASIX score (>1.27 vs. ≤1.27). RESULTS: scale. The baseline characteristics were similar between the two groups except for age. The high EASIX score group had worse RFS and OS than the low EASIX score group (log-rank p=0.001 and p=0.006, respectively). At 5 years, the mean RFS and OS difference between the low and high EASIX score groups was 11.1 and 7.35 months, respectively. High EASIX score remained a key prognosticator of RFS and OS after RNU in multivariable analysis. CONCLUSIONS: EASIX score may represent endothelial dysfunction in patients with UTUC and may serve as a readily available prognostic factor for oncologic outcomes.

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Cite This Study

Gu et al. (2022) conducted a cohort in Upper tract urothelial carcinoma (n=380). High EASIX score (>1.27) vs. Low EASIX score (≤1.27) was evaluated on Recurrence-free survival (median months) (HR 1.68, 95% CI 1.22-2.30, p=0.001). A high endothelial activation and stress index score was independently associated with worse recurrence-free survival (HR 1.68) and overall survival (HR 1.71) in upper tract urothelial carcinoma.

synapsesocial.com/papers/6a0a5831fdd00ab7863dcb80https://doi.org/10.4111/icu.20220204
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