Cancer - Bladder, Pelvis, Ureter & Others(구연) (NP-010) 근치적 신요관절제술 및 방광소매절제술을 시행한 환자에서 술전 혈소판증가의 임상적 의미 영남대학교 의과대학 비뇨의학교실 김영욱, 장준보, 최재영, 고영휘, 문기학, 정희창, 송필현 INTRODUCTION: In urothelial carcinoma of the bladder, preoperative thrombocytosis (PTC) has been identified as a predictor for oncologic outcome and survival after radical cystectomy. The aim of this study was to investigate the influence of an elevated platelet count (PC) in patients undergoing radical nephroureterectomy with bladder cuff excision (NUx) for urothelial carcinoma (UC) from renal calyx to distal ureter on the oncological prognosis. Furthermore, correlation of PTC with pathological parameters and perioperative blood transfusion (PBT) rates were analyzed. MATERIALS & METHODS: A retrospective analysis of 91 patients undergoing NUx for UC between 2005 and 2018 was performed. For the cohort PTC was defined as a platelet count > 450 G/. Chi-square test was used to analyze the association of PTC with categorical variables including tumor stage, grade and perioperative BT parameters. Cox regression analyses were used to investigate the association of PTC with outcome. RESULTS: The median age of patients at the moment of each operation was 66 years, 20.87% were female and 79.13% were male. The median PPC in the cohort was 272 G/l. PTC was detected in 29.67% of the patients. The median follow-up was 48 months. The cancer specific survival adapted to PTC (thrombocytes:< 450 G/l vs. > 450 G/l) was 98.2% vs. 92.6% after 1 years and 92.0% vs. 12.1% after 5 years, respectively. PTC was significantly associated with muscle invasion, periureteral fat invasion and lymphovascular invasion (p<0.001). PTC was also significantly associated with a higher rate of PBT (62.96% vs. 58.82%; p<0.001). In the multivariate analysis PTC was significantly related to poor oncological survival (Hazard Ratio=6.062; p=0.009). CONCLUSIONS: In this study, PTC was significantly associated with impaired oncological outcomes of patients undergoing NUx for UC. It represents an independent prognostic factor in oncological outcomes after NUx and therefore can help to identify patients with poor prognosis. And PTC is significantly correlated to an increased rate of PBT, which can be explained through tumor associated alterations of hemostasis. keywords : Ureteral Cancer, Nephroureterectomy, Thrombocytosis