PROGNOSTIC FACTORS IN ADVANCED BLADDER CANCER: A REAL-WORLD RETROSPECTIVE ANALYSIS

Zeynep Alaca TOPÇU, Mehmet Akif ÖZTÜRK, Mahmut Emre YILDIRIM, Rukiye ARIKAN, Tuğba BAŞOĞLU, Nazım Can DEMİRCAN, Tuğba Akın TELLİ, Özlem ERCELEP, Perran Fulden YUMUK, Faysal DANE

Haydarpaşa Numune Medical Journal - 2026;66(3):362-369

Department of Internal Medicine, Marmara University Faculty of Medicine, İstanbul, Türkiye

 

Introduction: Metastatic bladder cancer (mBC) is associated with poor outcomes. Despite advances in immunotherapy and targeted agents, platinum-based chemotherapy remains a cornerstone of treatment in real-world practice. We aimed to identify pragmatic and readily available prognostic factors for risk stratification in patients with mBC. Methods: This retrospective multicenter study included 121 patients with mBC treated at two high-volume oncology centers. Clinicopathological and laboratory parameters at the time of metastatic diagnosis were analyzed. The primary endpoint was overall survival (OS). Results: The median age was 66 years, and 90% of patients were male. The most common metastatic sites were abdominal lymph nodes (71.9%), bone (52.9%), lung (41.3%), and liver (27.3%). On multivariable analysis, Eastern Cooperative Oncology Group Performance Status >=2 (hazard ratio [HR] 1.80 (1.04-3.14), p=0.036), low hemoglobin (HR 1.67 (1.01-2.77), p=0.046), hypoalbuminemia (HR 2.08 (1.24-3.50), p=0.006), and leukocytosis (HR 2.26 (1.32-3.87), p=0.003) were independently associated with inferior OS. Discussion and Conclusion: Poor performance status, low hemoglobin levels, hypoalbuminemia, and leukocytosis at metastatic diagnosis are independent predictors of worse survival. These simple, cost-effective parameters may support risk stratification and clinical decision-making, particularly in settings where access to novel therapies is limited.