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
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Original Article
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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

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1. Medipol University Faculty of Medicine Çamlıca Hospital, Department of Urology, İstanbul, Turkey
2. Anadolu Health Center Department of Urology, Kocaeli, Turkey
3. Çukurova University Faculty of Medicine Department of Urology, Adana, Turkey
4. Ankara University Faculty of Medicine Department of Urology, Ankara, Turkey
5. Kocaeli University Faculty of Medicine Department of Urology, Kocaeli, Turkey
6. University of Health Sciences Turkey İstanbul Education and Research Hospital Clinic of Urology, İstanbul, Turkey
7. Hacettepe University Faculty of Medicine Department of Urology, Ankara, Turkey
8. University of Health Sciences Turkey Fatih Sultan Mehmet Education and Research Hospital, Clinic of Urology, İstanbul, Turkey
9. Marmara University Faculty of Medicine Department of Urology, İstanbul, Turkey
No information available.
No information available
Received Date: 10.03.2024
Accepted Date: 21.05.2024
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Abstract

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.

Keywords: Bladder cancer, cystectomy, prognosis

References

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