Supplementary Material for: The Influence of Preoperative Hydronephrosis on the Prognosis after Radical Cystectomy among Patients with Different Pathological Stages of Bladder Cancer

<b><i>Introduction:</i></b> Preoperative hydronephrosis is closely associated with the prognosis of patients with bladder cancer. This study assesses the effect of preoperative hydronephrosis on the prognosis after radical cystectomy (RC) among patients with different pathological stages of bladder urothelial carcinoma. <b><i>Methods:</i></b> We retrospectively analyzed the clinical data of 231 patients who underwent RC because of bladder urothelial carcinoma at our institution from January 2013 to December 2017. The overall survival (OS) in patients with or without preoperative hydronephrosis was followed up and compared, and the prognostic role that preoperative hydronephrosis played in patients with different pathological stages of bladder cancer was analyzed. Multivariate analysis was performed with the help of Cox proportional hazards regression models, the postoperative survival was analyzed with the help of Kaplan-Meier plots and log-rank test, and the <i>p</i> values of multiple testing were corrected using the Bonferroni correction. <b><i>Results:</i></b> Of 231 patients, 96 were patients with preoperative hydronephrosis and 115 patients had died by the end of the follow-up. Survival analysis found the 3- and 5-year survival rates after radical surgery of patients with preoperative hydronephrosis were significantly lower than those of patients without preoperative hydronephrosis (<i>p</i> &lt; 0.001). Multivariate analysis found preoperative hydronephrosis, T stage of tumor, and lymphatic metastasis were independent influencing factors of postoperative OS (<i>p</i> &lt; 0.05). Survival analysis of subgroups according to pathological stages found in pT_3–4N₀M₀ patients had a significant difference in postoperative survival between the group with preoperative hydronephrosis and the group without preoperative hydronephrosis (<i>p</i> &lt; 0.0001). <b><i>Conclusion:</i></b> The results indicate that preoperative hydronephrosis mainly affects postoperative OS in the patients whose pathological stage of bladder cancer is pT_3–4N₀M₀.

**引言：** 术前肾积水与膀胱癌患者的预后密切相关。本研究旨在评估术前肾积水对不同病理分期膀胱尿路上皮癌患者行根治性膀胱切除术（radical cystectomy, RC）后的预后影响。
**方法：** 我们回顾性分析了2013年1月至2017年12月于本机构因膀胱尿路上皮癌行根治性膀胱切除术的231例患者的临床资料。对合并与未合并术前肾积水的患者的总生存期（Overall Survival, OS）进行随访并比较，分析术前肾积水在不同病理分期膀胱癌患者中的预后价值。采用Cox比例风险回归模型开展多因素分析，通过Kaplan-Meier生存曲线与log-rank检验分析术后生存情况，并使用Bonferroni校正法对多重检验的P值进行校正。
**结果：** 231例患者中，96例合并术前肾积水，随访截止时共有115例患者死亡。生存分析显示，合并术前肾积水的患者行根治性膀胱切除术后的3年、5年生存率显著低于未合并术前肾积水的患者（*P* < 0.001）。多因素分析显示，术前肾积水、肿瘤T分期与淋巴转移均为术后总生存期的独立影响因素（*P* < 0.05）。按病理分期进行的亚组生存分析显示，在pT₃–₄N₀M₀患者中，合并与未合并术前肾积水的两组患者术后生存情况存在显著差异（*P* < 0.0001）。
**结论：** 本研究结果表明，术前肾积水主要影响病理分期为pT₃–₄N₀M₀的膀胱癌患者的术后总生存期。