The Cancer of the Bladder Risk Assessment Score and Mortality-Survival Relationship Among Patients Who Have Undergone Radical Cystectomy in the Turkish Urooncology Association Database

Objective: The Cancer of the Bladder Risk Assessment (COBRA) score is a practical method that can be used to predict survival in patients who have undergone radical cystectomy (RC). We aimed to evaluate COBRA scores in our patient group.Materials and Methods: Patients were classified a ccording t o t umor stage a nd l ymph n ode ( TLN) involvement; m ortality rates a nd s urvival w ere analyzed according to both the TLN classification and COBRA score from the Turkish Urooncology Association database. The chi-square test and Fisher-Freeman-Halton Exact chi-square test were used to compare qualitative data as well as descriptive statistical methods. Cox regression analysis was used for multivariate analysis. Kaplan- Meier and log-rank tests were used for survival analysis.Results: There was a statistically significant difference b etween t he C OBRA s cores a nd s urvival rates i n t erms o f c ancer-specific mo rtality ac cording to TLN classification ( p=0.000; p <0.05). A C OBRA s core o f 6 w as associated w ith a l ower m ortality rate t han a C OBRA s core o f 5 . I n t he C ox regression a nalysis of cancer-related death, a one-unit increase in the COBRA score increased the cancer-related death rate 1.54-fold [hazard ratio (HR)=1.540; 95% confidence interval (CI)=1.402-1.691] (p<0.05). When the COBRA score was compared to 0, the highest risk was observed for COBRA 5. If the COBRA score was 5, the risk of cancer-related death increased 14.63 times (HR=14.627; 95% CI=7.041-30.385) (p<0.05). If the COBRA score was 6, the risk of cancer-related death increased by 11.54 times (HR=11.547; 95% CI=5.270-25.278) (p<0.05).Conclusion: The COBRA score increased, the prognosis worsened, and our results are consistent with the first validated study.