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Preoperative low plasma creatine kinase levels predict worse survival outcomes in bladder cancer after radical cystectomy

  • Urology - Original Paper
  • Published:
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Abstract

Background and aims

To evaluate the prognostic significance of preoperative creatine kinase (CK) levels in bladder cancer (BCa) patients who underwent radical cystectomy (RC).

Materials and methods

570 BCa patients with RC were identified between 2010 and 2020. 108.5 U/L of CK levels were defined as the cutoff value. Logistic regression analysis and Cox regression models were performed to evaluate the association between CK levels and oncologic outcomes. Subgroup analyses were performed to address cofounding factors.

Results

Preoperative low CK levels were associated with worse recurrence-free survival (RFS, log-rank P = 0.001) and overall survival (OS, log-rank P = 0.002). Multivariate analysis revealed that preoperative low CK levels were an independent predictor for worse RFS (hazard ratio [HR]: 1.683; P < 0.001) and OS (HR: 1.567; P = 0.002).

Conclusions

The preoperative low CK level independently predicts worse survival outcomes in BCa after RC. Incorporating it into prediction models might be valuable to assist risk stratification.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Abbreviations

BCa:

Bladder cancer

RC:

Radical cystectomy

MIBC:

Muscle invasive bladder cancer

NMIBC:

Nonmuscle invasive bladder cancer

CK:

Creatine kinase

BMI:

Body mass index

WHO:

World Health Organization

AJCC:

American Joint Committee on Cancer

ROC:

Receiver operating characteristic

RFS:

Recurrence-free survival

OS:

Overall survival

HR:

Hazard ratio

CI:

Confidence interval

PSM:

Positive surgical margin

OR:

Odds ratio

ATP:

Adenosine triphosphate

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Funding

This study was supported by grants from the National Natural Science Foundation of China (82070784, 81702536) to J. A., a grant from Science and Technology Department of Sichuan Province, China (2022JDRC0040) to J. A., grants from The National Natural Science Foundation of China (Grant Nos. 81974099, 82170785) to L.Y., a grant from Science and Technology Department of Sichuan Province (Grant Nos. 21GJHZ0246) to L.Y., a grant from Young Investigator Award of Sichuan University 2017 (Grant No. 2017SCU04A17) to L.Y., a grant from Sichuan University–Panzhihua science and technology cooperation special fund (2020CDPZH-4) to L.Y., grants from The National Natural Science Foundation of China (Grant Nos. 81974099, 82170785) to Q.W. China Postdoctoral Science Foundation (No. 2021M692306; 2022T150455) and Post-Doctor Research Project of West China Hospital of Sichuan University (2021HXBH025) to X.Z.

Author information

Author notes

  1. Yifan Li, Hang Xu and Tianhai Lin have contributed this study equally.

Authors and Affiliations

  1. Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China

    Yifan Li, Hang Xu, Tianhai Lin, Jiapeng Zhang, Jianzhong Ai, Shiyu Zhang, Weizhen Le, Ping Tan, Peng Zhang, Qiang Wei, Xiaonan Zheng & Lu Yang

  2. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China

    Yifan Li, Hang Xu, Tianhai Lin, Jiapeng Zhang, Jianzhong Ai, Shiyu Zhang, Weizhen Le, Ping Tan, Peng Zhang, Qiang Wei, Xiaonan Zheng & Lu Yang

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  1. Yifan Li
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Contributions

Conceptualization, YL, HX and TL; Methodology, YL, HX, TL, JZ, SZ, WL, and XZ; Manuscript draft: YL, XH; Data curation and Project administration: YL, HX, JZ, TL, SZ and WL. Formal analysis: YL, HX, TL and JA; Investigation, QW, PT and LY; Writing, YL, HX and JZ; Supervision, QW, PZ, XZ, PT and LY. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xiaonan Zheng or Lu Yang.

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Appendix

Appendix

See Table 4 here.

Table 4 Logistic regression analysis of creatine kinase levels (continuous) variables for adverse pathologic outcomes
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Li, Y., Xu, H., Lin, T. et al. Preoperative low plasma creatine kinase levels predict worse survival outcomes in bladder cancer after radical cystectomy. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-03957-2

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