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- Title
Prognostic value of the systemic immune-inflammation index in non-muscle invasive bladder cancer.
- Authors
Katayama, Satoshi; Mori, Keiichiro; Pradere, Benjamin; Laukhtina, Ekaterina; Schuettfort, Victor M.; Quhal, Fahad; Motlagh, Reza Sari; Mostafaei, Hadi; Grossmann, Nico C.; Rajwa, Pawel; Moschini, Marco; Mathieu, Romain; Abufaraj, Mohammad; D'Andrea, David; Compérat, Eva; Haydter, Martin; Egawa, Shin; Nasu, Yasutomo; Shariat, Shahrokh F.
- Abstract
Purpose: We assessed the prognostic value of systemic immune-inflammation index (SII) to refine risk stratification of the heterogeneous spectrum of patients with non-muscle-invasive bladder cancer (NMIBC) Methods: In this multi-institutional cohort, preoperative blood-based SII was retrospectively assessed in 1117 patients with NMIBC who underwent transurethral resection of bladder (TURB) between 1996 and 2007. The optimal cut-off value of SII was determined as 580 using the best Youden index. Cox regression analyses were performed. The concordance index (C-index) and decision curve analysis (DCA) were used to assess the discrimination of the predictive models. Results: Overall, 309 (28%) patients had high SII. On multivariable analyses, high SII was significantly associated with worse PFS (hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.23–2.77; P = 0.003) and CSS (HR 2.53; 95% CI 1.42–4.48; P = 0.001). Subgroup analyses, according to the European Association of Urology guidelines, demonstrated the main prognostic impact of high SII, with regards to PFS (HR 3.39; 95%CI 1.57–7.31; P = 0.002) and CSS (HR 4.93; 95% CI 1.70–14.3; P = 0.005), in patients with intermediate-risk group; addition of SII to the standard predictive model improved its discrimination ability both on C-index (6% and 12%, respectively) and DCA. In exploratory intergroup analyses of patients with intermediate-risk, the improved discrimination ability was retained the prediction of PFS and CSS. Conclusion: Preoperative SII seems to identify NMIBC patients who have a worse disease and prognosis. Such easily available and cheap standard biomarkers may help refine the decision-making process regarding adjuvant treatment in patients with intermediate-risk NMIBC.
- Subjects
BLADDER cancer; CANCER invasiveness; PROGNOSIS; DECISION making; REGRESSION analysis; PREDICTION models; UROTHELIUM
- Publication
World Journal of Urology, 2021, Vol 39, Issue 12, p4355
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-021-03740-3