The Impact of Variant Histology in Patients with Urothelial Carcinoma Treated with Radical Cystectomy: Can We Predict the Presence of Variant Histology?

Considering the divergent biological behaviors of certain histological subtypes of urothelial carcinoma, it would be of great importance to examine the impact of variant histology and to predict its presence in patients with bladder cancer. A single-center cohort study included 459 patients who underwent radical cystectomy for urothelial carcinoma between 2017 and 2021. Patients were followed up with until July 2022. We compared clinical, laboratory, and histopathologic characteristics and the overall survival between patients with pure urothelial carcinoma and variant histologies. Our results showed that the patients with variant histology were older and preoperatively more frequently had hydronephrosis and higher values of leukocytes and neutrophils. Also, we found a significant association between variant histology and an advanced stage of tumor disease, the presence of lymphovascular invasion, positive surgical margins, and metastases in surgically resected lymph nodes. The number of neutrophils was identified as an independent preoperative predictor of the presence of variant histology after a radical cystectomy. The overall survival of the patients with variant histology was significantly lower compared to the patients with pure urothelial carcinoma. According to our results, the presence of variant histology represents a more aggressive form of the disease. Preoperative neutrophil counts may indicate the presence of variant histology of urothelial carcinoma in patients with bladder cancer.

Predictive Value of Inflammatory and Nutritional Indexes in the Pathology of Bladder Cancer Patients Treated with Radical Cystectomy.

In recent years, the focus of numerous studies has been the predictive value of inflammatory and nutritional parameters in oncology patients. The aim of our study was to examine the relationship between the inflammatory and nutritional parameters and the histopathological characteristics of patients with bladder cancer. A retrospective study included 491 patients who underwent radical cystectomy for bladder cancer between 2017 and 2021. We calculated the preoperative values of the neutrophil-to-lymphocyte ratio (NLR), the derived neutrophil-to-lymphocyte ratio (dNLR), the systemic immune-inflammation index (SII), the systemic inflammatory response index (SIRI), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR), the prognostic nutritional index (PNI), and the geriatric nutritional risk index (GNRI). Statistically significant positive correlations were observed between NLR, dNLR, SII, SIRI, and PLR and the pathological stage of the tumor. We observed statistically significant inverse correlations for LMR, PNI, and GNRI with the tumor stage. SIRI was identified as an independent predictor of the presence of LVI. dNLR was identified as an independent predictor of positive surgical margins. GNRI was identified as an independent predictor of the presence of metastases in the lymph nodes. We noticed the predictive value of SIRI, dNLR, and GNRI in the pathology of bladder cancer patients.

Validation of the Serbian version of the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Questionnaire short form (PISQ-12).

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) and pelvic organ prolapse (POP) significantly decrease quality of life and sexual health. This study aimed to evaluate the reliability and validity of a Serbian adaptation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) used in assessing sexual function in women with UI and/or POP. METHODS: This study included 416 women, 310 (74.5%) with UI and/or POP and 106 (25.5%) without UI and/or POP. The adaptation of the PISQ-12 to Serbian language was performed via back-translation. The content validity of the questionnaire was conducted by experts in the field. The reliability and validity of the PISQ-12 were analyzed. Evaluation of the data was performed using Content Validity Index (CVI), Cronbach's alpha, test-retest reliability, item total correlation and confirmatory factor analysis. RESULTS: Content validity of the Serbian PISQ-12 was 1.00 (100%). Item total correlations were between 0.459 and 0.819 (P < 0.001). The PISQ-12 had an adequate and high internal consistency (Cronbach's alpha 0.806) as well as high test-retest reliability (Pearson correlation coefficient r = 0.807; P < 0.001). Factor analysis results revealed strong construct validity. The mean scores of PISQ-12 were significantly better in the control group compared with the women with UI and/or POP. Sexual function was negatively affected by UI and/or POP as assessed with SF-36 and I-QoL questionnaires. CONCLUSIONS: This study showed that the Serbian version of the PISQ-12 is a reliable, consistent, valid and condition-specific instrument to assess sexual function in women with UI and/or POP.