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For: Laukhtina E, Pradere B, D Andrea D, Rosiello G, Luzzago S, Pecoraro A, Palumbo C, Knipper S, Karakiewicz PI, Margulis V, Quhal F, Sari Motlagh R, Mostafaei H, Mori K, Kimura S, Enikeev D, Shariat SF. Association of preoperative serum De Ritis ratio with oncological outcomes in patients treated with cytoreductive nephrectomy for metastatic renal cell carcinoma. Urol Oncol 2020;38:936.e7-936.e14. [PMID: 32962909 DOI: 10.1016/j.urolonc.2020.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/23/2020] [Accepted: 08/05/2020] [Indexed: 01/28/2023]

For:	Laukhtina E, Pradere B, D Andrea D, Rosiello G, Luzzago S, Pecoraro A, Palumbo C, Knipper S, Karakiewicz PI, Margulis V, Quhal F, Sari Motlagh R, Mostafaei H, Mori K, Kimura S, Enikeev D, Shariat SF. Association of preoperative serum De Ritis ratio with oncological outcomes in patients treated with cytoreductive nephrectomy for metastatic renal cell carcinoma. Urol Oncol 2020;38:936.e7-936.e14. [PMID: 32962909 DOI: 10.1016/j.urolonc.2020.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/23/2020] [Accepted: 08/05/2020] [Indexed: 01/28/2023]

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Cited by Other Article(s)

Laukhtina E, Schuettfort VM, D'Andrea D, Pradere B, Quhal F, Mori K, Sari Motlagh R, Mostafaei H, Katayama S, Grossmann NC, Rajwa P, Karakiewicz PI, Schmidinger M, Fajkovic H, Enikeev D, Shariat SF. Selection and evaluation of preoperative systemic inflammatory response biomarkers model prior to cytoreductive nephrectomy using a machine-learning approach. World J Urol 2022;40:747-754. [PMID: 34671856 PMCID: PMC8948147 DOI: 10.1007/s00345-021-03844-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/03/2021] [Indexed: 11/27/2022] Open

Abstract

INTRODUCTION

This study aimed to determine the prognostic value of a panel of SIR-biomarkers, relative to standard clinicopathological variables, to improve mRCC patient selection for cytoreductive nephrectomy (CN).

MATERIAL AND METHODS

A panel of preoperative SIR-biomarkers, including the albumin-globulin ratio (AGR), De Ritis ratio (DRR), and systemic immune-inflammation index (SII), was assessed in 613 patients treated with CN for mRCC. Patients were randomly divided into training and testing cohorts (65/35%). A machine learning-based variable selection approach (LASSO regression) was used for the fitting of the most informative, yet parsimonious multivariable models with respect to prognosis of cancer-specific survival (CSS). The discriminatory ability of the model was quantified using the C-index. After validation and calibration of the model, a nomogram was created, and decision curve analysis (DCA) was used to evaluate the clinical net benefit.

RESULTS

SIR-biomarkers were selected by the machine-learning process to be of high discriminatory power during the fitting of the model. Low AGR remained significantly associated with CSS in both training (HR 1.40, 95% CI 1.07-1.82, p = 0.01) and testing (HR 1.78, 95% CI 1.26-2.51, p = 0.01) cohorts. High levels of SII (HR 1.51, 95% CI 1.10-2.08, p = 0.01) and DRR (HR 1.41, 95% CI 1.01-1.96, p = 0.04) were associated with CSS only in the testing cohort. The exclusion of the SIR-biomarkers for the prognosis of CSS did not result in a significant decrease in C-index (- 0.9%) for the training cohort, while the exclusion of SIR-biomarkers led to a reduction in C-index in the testing cohort (- 5.8%). However, SIR-biomarkers only marginally increased the discriminatory ability of the respective model in comparison to the standard model.

CONCLUSION

Despite the high discriminatory ability during the fitting of the model with machine-learning approach, the panel of readily available blood-based SIR-biomarkers failed to add a clinical benefit beyond the standard model.

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Affiliation(s)

Ekaterina Laukhtina Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
Victor M Schuettfort Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
David D'Andrea Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
Benjamin Pradere Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
Fahad Quhal Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
Keiichiro Mori Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
Reza Sari Motlagh Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Hadi Mostafaei Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Satoshi Katayama Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Nico C Grossmann Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Department of Urology, University Hospital Zurich, Zurich, Switzerland
Pawel Rajwa Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Department of Urology, Medical University of Silesia, Zabrze, Poland
Pierre I Karakiewicz Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
Manuela Schmidinger Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
Harun Fajkovic Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
Dmitry Enikeev Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
Shahrokh F Shariat Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. Department of Urology, Weill Cornell Medical College, New York, NY, USA. Department of Urology, University of Texas Southwestern, Dallas, TX, USA. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.

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Li J, Cao D, Peng L, Meng C, Xia Z, Li Y, Wei Q. Potential Clinical Value of Pretreatment De Ritis Ratio as a Prognostic Biomarker for Renal Cell Carcinoma. Front Oncol 2021;11:780906. [PMID: 34993141 PMCID: PMC8724044 DOI: 10.3389/fonc.2021.780906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/25/2021] [Indexed: 01/04/2023] Open

Rajwa P, Huebner NA, Hostermann DI, Grossmann NC, Schuettfort VM, Korn S, Quhal F, König F, Mostafaei H, Laukhtina E, Mori K, Motlagh RS, Yanagisawa T, Aydh A, Bryniarski P, Pradere B, Paradysz A, Baltzer PA, Grubmüller B, Shariat SF. Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy. J Pers Med 2021;11:jpm11111231. [PMID: 34834583 PMCID: PMC8625876 DOI: 10.3390/jpm11111231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 02/02/2023] Open

Abstract

The aim of this study was to assess the predictive value of pre-biopsy blood-based markers in patients undergoing a fusion biopsy for suspicious prostate magnetic resonance imaging (MRI). We identified 365 consecutive patients who underwent MRI-targeted and systematic prostate biopsy for an MRI scored Prostate Imaging–Reporting and Data System Version (PI-RADS) ≥ 3. We evaluated the neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), lymphocyte/monocyte ratio (LMR,) de Ritis ratio, modified Glasgow Prognostic Score (mGPS), and prognostic nutrition index (PNI). Uni- and multivariable logistic models were used to analyze the association of the biomarkers with biopsy findings. The clinical benefits of biomarkers implemented in clinical decision-making were assessed using decision curve analysis (DCA). In total, 69% and 58% of patients were diagnosed with any prostate cancer and Gleason Grade (GG) ≥ 2, respectively. On multivariable analysis, only high dNLR (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.23–5.56, p = 0.02) and low PNI (OR 0.48, 95% CI 0.26–0.88, p = 0.02) remained independent predictors for GG ≥ 2. The logistic regression models with biomarkers reached AUCs of 0.824–0.849 for GG ≥ 2. The addition of dNLR and PNI did not enhance the net benefit of a standard clinical model. Finally, we created the nomogram that may help guide biopsy avoidance in patients with suspicious MRI. In patients with PI-RADS ≥ 3 lesions undergoing MRI-targeted and systematic biopsy, a high dNLR and low PNI were associated with unfavorable biopsy outcomes. Pre-biopsy blood-based biomarkers did not, however, significantly improve the discriminatory power and failed to add a clinical benefit beyond standard clinical factors.

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Affiliation(s)

Pawel Rajwa Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland; (P.B.); (A.P.) Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Correspondence: ; Tel./Fax: +48-32-37-04-405
Nicolai A. Huebner Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Working Group for Diagnostic Imaging in Urology (ABDU), Austrian Association of Urology (ÖGU), 1090 Vienna, Austria
Dadjar I. Hostermann Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
Nico C. Grossmann Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Department of Urology, Luzerner Kantonsspital, 6000 Lucerne, Switzerland Department of Urology, University Hospital Zurich, 8091 Zurich, Switzerland
Victor M. Schuettfort Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Department of Urology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
Stephan Korn Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
Fahad Quhal Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Department of Urology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
Frederik König Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Department of Urology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
Hadi Mostafaei Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz 51666-15731, Iran
Ekaterina Laukhtina Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Institute for Urology and Reproductive Health, Sechenov University, 19435 Moscow, Russia
Keiichiro Mori Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Department of Urology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
Reza Sari Motlagh Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran
Takafumi Yanagisawa Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Department of Urology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
Abdulmajeed Aydh Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Department of Urology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
Piotr Bryniarski Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland; (P.B.); (A.P.)
Benjamin Pradere Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
Andrzej Paradysz Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland; (P.B.); (A.P.)
Pascal A. Baltzer Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
Bernhard Grubmüller Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.)
Shahrokh F. Shariat Department of Urology, Medical University of Vienna, 1090 Vienna, Austria; (N.A.H.); (D.I.H.); (N.C.G.); (V.M.S.); (S.K.); (F.Q.); (F.K.); (H.M.); (E.L.); (K.M.); (R.S.M.); (T.Y.); (A.A.); (B.P.); (B.G.); (S.F.S.) Institute for Urology and Reproductive Health, Sechenov University, 19435 Moscow, Russia Karl Landsteiner Institute of Urology and Andrology, 1010 Vienna, Austria Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan

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