Perioperative Hypothermia is a Prognostic Factor of Cystectomy Especially for Stage II Muscle-Invasive Bladder Cancer

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INTRODUCTION

Cystectomy is the standard treatment for muscle-invasive bladder cancer (MIBC). However, its risk factors and biomarkers identified as a prognostic factor such as postoperative recurrence can only be found in the pathological findings. In recent years, circulating tumor cells (CTCs) have been attracting much attention because it is considered that preventing postoperative engraftment of CTCs may reduce postoperative recurrence. It is also well known that hypothermia reduces humoral immunity of IL-6 and migration capacity of lymphocyte, which has traditionally been a contentious issue of the association between perioperative hypothermia and immunodeficiency in the fields of surgery and anesthesiology. These led us to the assumption that perioperative hypothermia may induce immunodeficiency and promote engraftment of CTCs and subsequently a poor prognosis. In this study, we compared the prognosis of cystectomy performed for MIBC between the hypothermia group and the normothermia group.

METHODS

Data were collected from a total of 124 patients who underwent cystectomy for MIBC at our department between 2003 and 2016. The patients were divided into the 2 groups according to the lowest perioperative body temperature, i.e., the hypothermia group (