Clinical Research Papers:

Preoperative hemoglobin-platelet ratio can significantly predict progression and mortality outcomes in patients with T1G3 bladder cancer undergoing transurethral resection of bladder tumor

Gang Tang _, Yunpeng Zhen, Wanqin Xie, Yinlei Wang, Feiran Chen, Chuan Qin, Han Yang, Zhiyong Du, Zhonghua Shen, Bo Zhang, Zhouliang Wu, Dawei Tian and Hailong Hu

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Oncotarget. 2018; 9:18627-18636. https://doi.org/10.18632/oncotarget.23896

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Gang Tang1,2, Yunpeng Zhen1,2, Wanqin Xie3, Yinlei Wang1,2, Feiran Chen1,2, Chuan Qin1,2, Han Yang1,2, Zhiyong Du1,2, Zhonghua Shen1,2, Bo Zhang1,2, Zhouliang Wu1,2, Dawei Tian1,2 and Hailong Hu1,2

1Department of Urology, The Second Hospital of Tianjin Medical University, Hexi District, Tianjin 300211, China

2Tianjin Key Laboratory of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China

3Key Laboratory of Genetics and Birth Health of Hunan Province, The Family Planning Research Institute of Hunan Province, Changsha, Hunan 410126, China

Correspondence to:

Dawei Tian, email: [email protected]

Hailong Hu, email: [email protected]

Keywords: HPR; T1G3 bladder cancer; PFS; OS; CSS

Received: June 28, 2016     Accepted: November 12, 2017     Epub: January 03, 2018     Published: April 06, 2018


Objective: To investigate the prognostic role of hematological biomarkers, especially hemoglobin-platelet ratio (HPR) in the oncological outcomes in stage 1 and grade 3 (T1G3) bladder cancer.

Materials and Methods: We identified 457 T1G3 bladder cancer patients who underwent transurethral resection of the bladder (TURB) between 2009 and 2014. Based on hematological parameters (hemoglobin-platelet ratio (HPR), hemoglobin, and platelet counts), recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (OS) and cancer-specific survival (CSS) were analyzed by using Kaplan-Meier analysis. Multivariate Cox regression model was adopted to identify the predictors of oncological outcomes.

Results: Kaplan-Meier survival analysis showed that low HPR (< 0.615), low hemoglobin (< 125g/l) and elevated platelet counts (> 240 x 103/μl) were correlated with poor OS. Low HPR, but not low hemoglobin and high platelet counts, is associated with worse PFS. Low HPR and low hemoglobin, but not elevated platelet counts, are associated with worse CSS. However, no significant difference was observed in RFS according to any of these hematological markers. On multivariate analysis, low HPR (HR = 1.27, 95% CI = 0.81–1.75, P = 0.030), low hemoglobin (HR = 1.20, 95% CI = 0.79–1.84, P = 0.028) and elevated platelet counts (HR = 1.07, 95% CI = 0.72–1.32, P = 0.038) were significantly associated with OS. Low hemoglobin (HR = 1.08, 95% CI = 0.68–1.82, P = 0.041) was significantly linked with CSS. Particularly, low HPR was identified as an independent predictor of PFS (HR = 1.16, 95% CI = 0.97–1.49, P = 0.033) and CSS (HR = 1.14, 95% CI = 0.87–1.78, P = 0.029).

Conclusions: Preoperative HPR can be taken into account as a factor predictive of oncological outcomes for T1G3 bladder cancer, particularly disease progression and mortality outcomes.

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