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      PA-MSHA improves prognosis of patients undergoing radical cystectomy: a retrospective cohort study using inverse probability of treatment weighting

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          Abstract

          Objective

          To observe the effect of Pseudomonas aeruginosa mannose-sensitive hemagglutinin (PA-MSHA) on the prognosis and the incidence of lymphatic leakage in patients undergoing radical cystectomy (RC).

          Method

          A total of 129 patients who underwent RC in Lanzhou University Second Hospital from 2013 to 2022 were enrolled in this study. They were divided into 43 patients treated with PA-MSHA and 86 patients in the control group. Inverse probability of treatment weighting (IPTW) was applied to reduce potential selection bias. Kaplan-Meier method and Cox regression analysis were used to analyze the effect of PA-MSHA on the survival of patients and the incidence of postoperative lymphatic leakage.

          Results

          The PA-MSHA group exhibited improved overall survival (OS) and cancer-specific survival (CSS) rates compared to the control group. The 3-year and 5-year overall survival (OS) rates for the PA-MSHA group were 69.1% and 53.2%, respectively, compared to 55.6% and 45.3% for the control group (Log-rank=3.218, P=0.072). The 3-year and 5-year cancer-specific survival (CSS) rates for the PA-MSHA group were 73.3% and 56.5%, respectively, compared to 58.0% and 47.3% for the control group (Log-rank=3.218, P=0.072). Additionally, the 3-year and 5-year progression-free survival (PFS) rates for the PA-MSHA group were 74.4% and 56.8%, respectively, compared to 57.1% and 52.2% for the control group (Log-rank=2.016, P=0.156). Multivariate Cox regression analysis indicates that lymph node metastasis and distant metastasis are poor prognostic factors for patients, while the use of PA-MSHA can improve patients’ OS (HR: 0.547, 95%CI: 0.304–0.983, P=0.044), PFS (HR: 0.469, 95%CI: 0.229–0.959, P=0.038) and CSS (HR: 0.484, 95%CI: 0.257–0.908, P=0.024). The same trend was observed in the cohort After IPTW adjustment. Although there was no significant difference in the incidence of postoperative lymphatic leakage [18.6% (8/35) vs. 15.1% (84.9%), P=0.613] and pelvic drainage volume [470 (440) ml vs. 462.5 (430) ml, P=0.814] between PA-MSHA group and control group, PA-MSHA could shorten the median retention time of drainage tube (7.0 d vs 9.0 d) (P=0.021).

          Conclusion

          PA-MSHA may improve radical cystectomy in patients with OS, PFS, and CSS, shorten the pelvic drainage tube retention time.

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          Most cited references30

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          European Association of Urology Guidelines on Non–muscle-invasive Bladder Cancer (Ta, T1, and Carcinoma in Situ)

          Marko Babjuk, Maximilian Burger, Otakar Čapoun … (2022)
          The European Association of Urology (EAU) has released an updated version of the guidelines on non-muscle-invasive bladder cancer (NMIBC).
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            Current best practice for bladder cancer: a narrative review of diagnostics and treatments

            Eva Comperat, Mahul B Amin, Richard Cathomas … (2022)
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              NCCN Guidelines® Insights: Bladder Cancer, Version 2.2022 : Featured Updates to the NCCN Guidelines

              Thomas W Flaig, Philippe Spiess, Michael Abern … (2022)
              The NCCN Guidelines for Bladder Cancer provide recommendations for the diagnosis, evaluation, treatment, and follow-up of patients with bladder cancer and other urinary tract cancers (upper tract tumors, urothelial carcinoma of the prostate, primary carcinoma of the urethra). These NCCN Guidelines Insights summarize the panel discussion behind recent important updates to the guidelines regarding the treatment of non–muscle-invasive bladder cancer, including how to treat in the event of a bacillus Calmette-Guérin (BCG) shortage; new roles for immune checkpoint inhibitors in non–muscle invasive, muscle-invasive, and metastatic bladder cancer; and the addition of antibody–drug conjugates for metastatic bladder cancer.
              Article 0 comments Cited 78 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Xiaohua Zhang: URI : https://loop.frontiersin.org/people/2725726Role: Role: Role: Role: Role: Role: Role:
                Zixu Pei: URI : https://loop.frontiersin.org/people/2694604Role: Role: Role: Role: Role:
                Jinglei Ren: URI : https://loop.frontiersin.org/people/2733104Role: Role: Role:
                Jing Shi: URI : https://loop.frontiersin.org/people/2769623Role: Role: Role:
                Wenjun Lu: URI : https://loop.frontiersin.org/people/2769630Role: Role:
                Yuan Shui: URI : https://loop.frontiersin.org/people/2769609Role: Role:
                Wentao Ma: URI : https://loop.frontiersin.org/people/2769603Role: Role:
                Luyang Zhang: Role: Role:
                Hui Ding: URI : https://loop.frontiersin.org/people/984706Role: Role:
                Yunxin Zhang: URI : https://loop.frontiersin.org/people/2769639Role: Role:
                Junqiang Tian: URI : https://loop.frontiersin.org/people/806713Role: Role:
                Zhiping Wang: URI : https://loop.frontiersin.org/people/1167396Role: Role: Role: Role: Role: Role: Role: Role:
                Journal
                Journal ID (nlm-ta): Front Immunol
                Journal ID (iso-abbrev): Front Immunol
                Journal ID (publisher-id): Front. Immunol.
                Title: Frontiers in Immunology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-3224
                Publication date (Electronic): 25 June 2024
                Publication date Collection: 2024
                Volume: 15
                Electronic Location Identifier: 1403302
                Affiliations
                [1] 1 Institute of Urology, Gansu Province Clinical Research Center for Urinary System Disease, The Second Hospital & Clinical Medical School, Lanzhou University , Lanzhou, China
                [2] 2 The Second Clinical Medical College of Lanzhou University , Lanzhou, Gansu, China
                [3] 3 The First Clinical Medical College of Lanzhou University , Lanzhou, Gansu, China
                Author notes

                Edited by: Arya Mariam Roy, University at Buffalo, United States

                Reviewed by: Lingao Ju, Wuhan University, China

                Xu Chen, Sun Yat-sen Memorial Hospital, China

                *Correspondence: Zhiping Wang, wangzplzu@ 123456163.com

                †These authors have contributed equally to this work

                Article
                DOI: 10.3389/fimmu.2024.1403302
                PMC ID: 11231181
                PubMed ID: 38983861
                SO-VID: 0aad3580-45fe-4f29-95ed-5e0128e99cff
                Copyright © Copyright © 2024 Zhang, Pei, Ren, Shi, Lu, Shui, Ma, Zhang, Ding, Zhang, Tian and Wang
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 19 March 2024
                Date accepted : 12 June 2024
                Page count
                Figures: 4, Tables: 2, Equations: 0, References: 30, Pages: 9, Words: 4377
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Natural Science Foundation of China (Grant No.82060459) and the Cuiying Plan Project of the Lanzhou University Second Hospital (Grant No.PR0201013).
                Categories
                Subject: Immunology
                Subject: Original Research
                Custom metadata
                section-in-acceptance Cancer Immunity and Immunotherapy

                ScienceOpen disciplines: Immunology
                Keywords: pseudomonas aeruginosa-mannose-sensitive hemagglutinin,bladder cancer,radical cystectomy,lymphatic leakage,inverse probability of treatment weighting,retrospective cohort study
                Data availability:
                ScienceOpen disciplines: Immunology
                Keywords: pseudomonas aeruginosa-mannose-sensitive hemagglutinin, bladder cancer, radical cystectomy, lymphatic leakage, inverse probability of treatment weighting, retrospective cohort study

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