Relationship of Systemic Immune-Inflammation Index and Neutrophil-Lymphocyte ratio with Disease Recurrence and Progression risk in Non-Muscle-Invasive Bladder Cancer

Abstract

Objective: Some systemic inflammatory response-based biomarkers are promising for predicting prognosis of non-muscle-invasive bladder cancer (NMIBC) patients and can contribute to the risk classification without any significant cost. We aimed to evaluate the neutrophil-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) for the prediction of recurrence and progression risk in patients with NMIBC. Material and Methods: The study included a retrospective analysis of 211 patients who underwent transurethral resection of bladder (TURB) in a tertiary referral center between 2015 and 2019. The receiver operating characteristic (ROC) curve was used to determine the cut-off value. The Kaplan-Meier curves and the log-rank test were constructed to evaluate the recurrence-free and progression-free survival rates according to different levels of inflammatory markers. The multivariate regression analysis was undertaken to estimate the independent prognostic factors. Results: The optimal cut-off value of SII was found to be 568 in the ROC analysis. According to the multivariate analysis, the SII value, number of tumors at the time of initial TURB, and European Organization for Research and Treatment of Cancer (EORTC) recurrence classification were statistically significant parameters in predicting recurrence. While tumor size, NLR, and SII achieved statistically significant levels in the univariate analysis, they didn’t have significance in the multivariate analysis. Conclusion: The SII, number of tumors, and EORTC recurrence classification are prognostic parameters that can be used in the assessment of recurrence. However, inflammatory parameters do not have the same predictive ability in the prediction of the progression rate.

Keywords

• Bladder cancer
• progression
• recurrence
• systemic immune-inflammation index

Kasa İnvaze Olmayan Mesane Kanserinde Sistemik İmmün-İnflamasyon İndeksi ve Nötrofil-Lenfosit Oranının Hastalık Nüksü ve İlerleme Riski ile İlişkisi

Abstract

Amaç: Sistemik inflamatuar yanıta dayalı biyobelirteçler, kasa invaze olmayan mesane kanseri (KİOMK) hastalarının prognozunu tahmin etmede umut vericidir ve düşük maliyetle risk sınıflandırmasına katkıda bulunabilir. Bu çalışmada, KİOMK hastalarındahastalığın nüks ve progresyon riskinin öngörülmesi için nötrofil-lenfosit oranı (NLO) ve sistemik immün-inflamasyon indeksini (Sİİ) değerlendirmeyi amaçladık. Gereç ve Yöntemler: Çalışma, 2015-2019 yılları arasında üçüncü basamak bir üroloji merkezinde transüretral mesane tümörü rezeksiyonu (TUR-MT) uygulanan 211 hastanın verilerinin retrospektif bir analizini içeriyor. Eşik değeri belirlemek için receiver operating characteristic (ROC) eğrisi kullanıldı. Kaplan-Meier eğrileri ve log-rank testi, farklı inflamatuar belirteç seviyelerine göre nükssüz ve progresyonsuz sağkalım oranlarını değerlendirmek için kullanıldı. Bağımsız prognostik faktörleri tahmin etmek için çok değişkenli regresyon analizi yapıldı. Bulgular: ROC analizinde SII’nın optimal eşik değeri 568 olarak bulundu. Çok değişkenli analize göre, SII değeri, ilk TUR-MT sırasındaki tümör sayısı ve Avrupa Kanser Araştırma ve Tedavi Örgütü (EORTC) nüks sınıflandırması, nüksü öngörmede istatistiksel olarak anlamlı parametrelerdi. Tek değişkenli analizde tümör boyutu, NLO ve SII istatistiksel olarak anlamlı seviyelere ulaşırken, çok değişkenli analizde anlamlı değildi. Sonuç: SII, tümör sayısı ve EORTC nüks sınıflaması, nüks değerlendirmesinde kullanılabilecek prognostik parametrelerdir. Ancak inflamatuar parametreler, progresyon hızını tahmin etmede aynı öngörü yeteneğine sahip değildir.

Keywords

• mesane kanseri
• progresyon
• nüks
• sistemik immün-inflamasyon indeksi

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