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January 1, 2022Investigative and Clinical UrologyOpen Access

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

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Why the study?

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

Population

Patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU)

Comparison

High endothelial activation and stress index score vs Low EASIX score (≤1.27)

Design

Cohort

Follow-up

5 years

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.

Authors

JGJin Seok GuJRJi Won RyuSYSeong Hyeon Yu

Discussion

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Member takes

Overview

Supports EASIX for UTUC prognostication; hypothesis-generating and requires prospective validation.

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

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

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.

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

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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