@article{c4428c6ca0a74ae7a795291a0aa81959,
title = "The significance of preoperative serum sodium and hemoglobin in outcomes of upper tract urothelial carcinoma: Multi-center analysis between china and the united states",
abstract = "Purpose: To analyze the effect of preoperative serum sodium and hemoglobin on oncologic outcomes in upper tract urothelial carcinoma (UTUC) based on a multi-center cohort from China and the United States (U.S.). Methods: We retrospectively reviewed the records of 775 patients with UTUC treated surgically at tertiary care medical facilities in China or the US from 1998 to 2015. We analyzed associations of preoperative serum sodium and hemoglobin with clinicopathological characteristics, overall survival (OS), cancer-specific survival (CSS) and intravesical recurrence free survival (IVRFS). Results: The US patients had comparatively lower serum sodium and similar hemoglobin at baseline. Preoperative low serum sodium value was associated with tumor multifocality, lymph node metastasis (LNM) and lymphovascular invasion (LVI); preoperative anemia was associated with advanced age, tumor multifocality, high tumor grade and LVI. Preoperative low serum sodium was an independent predictor of worse OS in the entire cohort; preoperative anemia was an independent predictor of worse OS and CSS in the US cohort alone, Chinese cohort alone and the combined cohort. We developed a predictive nomogram for OS which exhibited better prognostic value when it included the values of sodium and anemia, and successfully validated it in different cohorts. Conclusion: Preoperative low serum sodium and anemia could be informative in predicting worse pathologic and survival outcomes in different UTUC patient ethnic groups.",
keywords = "Anemia, China, Serum sodium, Survival, The United States, Upper tract urothelial carcinoma",
author = "Dong Fang and Nirmish Singla and Zhengqing Bao and Jafri, {Syed M.} and Xiaohong Su and Zhenpeng Cao and Gengyan Xiong and Lei Zhang and Solomon Woldu and Ryan Hutchinson and Arthur Sagalowsky and Yair Lotan and Xuesong Li and Raman, {Jay D.} and Vitaly Margulis and Liqun Zhou",
note = "Funding Information: Acknowledgments. The authors are very grateful to Dr. Ryan Pekson, Albert Einstein College of Medicine, for his valuable assistance with the preparation of some of the figures. This article is dedicated to the authors{\textquoteright} beloved co-author, colleague, and friend, Dr. Ellen B. Katz, who bravely worked on this manuscript in spite of her illness until the end. The authors regret that she was not able to see this work published. Funding. This work was supported by National Institutes of Health (NIH) grant R21 DK081194 (to M.J.C.), American Diabetes Association grant 1-13-CE-06 (to M.J.C.), and an NIH Ruth Kirschstein predoctoral fellowship (F31 DK093332 [to L.W.]). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. M.J.C. conceived the idea of the project, supervised all of the experiments, revised the figures, edited the manuscript, and provided funding. L.W. performed the experiments and produced the first draft of the manuscript. Y.S., X.Q.D., B.C., A.S., S.A.S., and E.B.K. provided intellectual input into the design of the project and assisted with some experiments. P.M.V. provided intellectual input into the design of the project and edited the manuscript. S.E.R. evaluated the data, interpreted the histopathology, and revised the manuscript. M.J.C. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Publisher Copyright: {\textcopyright} 2020, Dove Medical Press Ltd.. All rights reserved.",
year = "2020",
doi = "10.2147/CMAR.S267969",
language = "English (US)",
volume = "12",
pages = "9825--9836",
journal = "Cancer Management and Research",
issn = "1179-1322",
publisher = "Dove Medical Press Ltd.",
}