Preoperative Serum Apolipoprotein A-I Levels Predict Long-term Survival in Non-muscle-invasive Bladder Cancer Patients

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2018 May 26

PMID 29795989

Citations 9

Authors

Zhenhua Shang

Jukun Wang

Xu Wang

Hao Yan

Bo Cui

Chunsong Jia

Qi Wang

Xin Cui

Jin Li

Tongwen Ou

Affiliations

Soon will be listed here.

Abstract

Introduction: The aim of this study was to elucidate the association between apolipoprotein A-I (Apo A-I) and overall survival (OS) as well as cancer-specific survival (CSS) in non-muscle-invasive bladder cancer (NMIBC) patients undergoing transurethral resection of bladder tumor (TURBT).

Patients And Methods: We retrospectively collected data of 470 eligible patients diagnosed with NMIBC and who received TURBT between January 2004 and December 2011. Pretreatment blood indexes were examined. The association of Apo A-I with clinicopathological characteristics was further analyzed by dichotomizing our sample into those with Apo A-I ≤ 1.19 g/L (low Apo A-I group) and those with Apo A-I > 1.19 g/L (high Apo A-I group). OS and CSS were estimated by Kaplan-Meier analysis and the log-rank test was used to compare differences between groups. Univariate and multivariate Cox regression analyses were plotted to assess the prognostic value of Apo A-I in NMIBC patients. In addition, subgroup analyses were performed according to the risk classification of the International Bladder Cancer Group.

Results: In the overall population, patients in the high Apo A-I group had greater 5-year OS and 5-year CSS rates as compared to those in the low Apo A-I group. Kaplan-Meier survival analysis revealed that higher albumin, Apo A-I, and hemoglobin levels were associated with greater OS and CSS while elevated neutrophil-lymphocyte ratio was associated with worse OS and CSS in the overall and high-risk population rather than low- and intermediate-risk population. Furthermore, Apo A-I was shown to be an independent predictor in the overall population (for OS, hazard ratio [HR], 0.364, 95% confidence interval [CI], 0.221-0.598, < 0.001; for CSS, HR, 0.328, 95% CI, 0.185-0.583, < 0.001) and high-risk patients (for OS, HR, 0.232, 95% CI 0.121-0.443, < 0.001; for CSS, HR, 0.269, 95% CI, 0.133-0.541, < 0.001).

Conclusion: These results suggest that Apo A-I level could potentially serve as a useful prognostic indicator for therapeutic decision making in NMIBC patients.

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