title: Prognostic Impact of Renin-Angiotensin Inhibitors in Patients with Bladder Cancer Undergoing Radical Cystectomy.
abstract: BACKGROUND
  Renin-angiotensin system blockade has been effective for the treatment of patients with several types of malignancy. This study evaluated the prognostic impact of renin-angiotensin system inhibitors, including angiotensin-2 converting enzyme inhibitors and angiotensin 2 receptor blockers, in patients with bladder cancer undergoing radical cystectomy.
  
  
  METHODS
  This retrospective study included 269 patients who had undergone radical cystectomy. The oncologic outcomes of patients treated or not treated with renin-angiotensin system inhibitors after surgery were evaluated. Overall survival and cancer-specific survival were assessed by the Kaplan-Meier method and by Cox regression analysis.
  
  
  RESULTS
  The median follow-up duration after radical cystectomy in survivors was 44.5 months. The 5-year, cancer-specific survival rates in patients who did and did not receive renin-angiotensin system inhibitors were 79.0 and 66.4 %, respectively (P = 0.011). Similarly, the 5-year overall survival rates were 76.1 and 61.4 %, respectively (P = 0.0097). Multivariable analyses showed that use of renin-angiotensin system inhibitors was an independent prognostic factor for cancer-specific survival (hazard ratio 0.47, P = 0.036) and for overall survival (hazard ratio 0.36, P = 0.022).
  
  
  CONCLUSIONS
  Renin-angiotensin system inhibitors significantly reduced the risks of cancer-specific and overall mortality after radical cystectomy in patients with bladder cancer. Renin-angiotensin system inhibitors may improve oncologic outcomes in high-risk patients with bladder cancer.
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Kori Hospital, Osaka, Japan.|Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan. kinoshih@hirakata.kmu.ac.jp.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kinoshita
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Kori Hospital, Osaka, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Fukui
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, General Medical Center, Osaka, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Matsuzaki
authors.affiliation: Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Mishima
authors.affiliation: Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yanishi
authors.affiliation: Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Komai
authors.affiliation: Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Sugi
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, General Medical Center, Osaka, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, General Medical Center, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murota
authors.affiliation: Department of Urology and Andrology, Kansai Medical University Hospital, Osaka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000367:Age Factors; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000970:Antineoplastic Agents