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Teke K, Avci IE, Cinar NB, Baynal EA, Bosnali E, Polat S, Yilmaz H, Kara O, Dillioglugil O. Immune-inflammatory-nutritional status predicts oncologic outcomes after radical cystectomy for urothelial carcinoma of bladder. Actas Urol Esp 2023; 47:430-440. [PMID: 36731820 DOI: 10.1016/j.acuroe.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To perform the first investigation of the role of immune-inflammatory-nutritional status (INS) on oncological outcomes in patients undergoing open radical cystectomy (ORC) for urothelial carcinoma (UC). MATERIALS AND METHODS The records of consecutive patients who underwent ORC for non-metastatic bladder cancer between 2009 and 2020 were retrospectively analyzed. Neoadjuvant chemotherapy, non-urothelial tumor biology, and absence of oncological follow-up were exclusion criteria. Systemic immune-inflammatory index (SII) and Prognostic Nutritional Index (PNI) values were calculated and optimal cut-off values for these were used to designate four subgroups: "high SII-high PNI", "low SII-high PNI", "low SII-low PNI", and "high SII-low PNI". The Low SII-high PNI INS group had best overall survival (OS) rate while the remainder were included in non-favorable INS group. Survival curves were constructed, and a multivariate Cox regression model was used for OS and recurrence-free survival (RFS). RESULTS After exclusions, the final cohort size was 173 patients. The mean age was 64.31 ± 8.35 and median follow-up was 21 (IQR: 9-58) months. Optimal cut-off values for SII and PNI were 1216 and 47, respectively. The favorable INS group (low SII-high PNI, n = 89) had the best OS rate (62.9%). Multivariate Cox regression analysis indicated that non-favorable INS (n = 84) was a worse independent prognostic factor for OS (HR: 1.509, 95%CI: 1.104-3.145, p = 0.001) and RFS (HR: 1.285; 95%CI: 1.009-1.636, p = 0.042). CONCLUSION Preoperative assessment of INS may be a useful prognostic panel for OS and RFS in patients who had ORC for UC.
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Affiliation(s)
- K Teke
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - I E Avci
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey.
| | - N B Cinar
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - E A Baynal
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - E Bosnali
- Department of Urology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - S Polat
- Department of Urology, Amasya University, Amasya, Turkey
| | - H Yilmaz
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - O Kara
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - O Dillioglugil
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
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Teke K, Erkut Avci I, Burak Cinar N, Abdullah Baynal E, Bosnali E, Polat S, Yilmaz H, Kara O, Dillioglugil O. El estado inmunológico-inflamatorio-nutricional predice los resultados oncológicos tras la cistectomía radical por carcinoma urotelial de vejiga. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Napolitano L, Barone B, Reccia P, De Luca L, Morra S, Turco C, Melchionna A, Morgera V, Cirillo L, Fusco GM, Mirto BF, Napodano G, Del Biondo D, Prezioso D, Imbimbo C, Crocetto F. Preoperative monocyte-to-lymphocyte ratio as a potential predictor of bladder cancer. J Basic Clin Physiol Pharmacol 2022; 33:751-757. [PMID: 35985034 DOI: 10.1515/jbcpp-2022-0179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 07/28/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the role of preoperative Monocyte-to-Lymphocyte ratio (MLR) as a potential predictor of bladder cancer (BC). METHODS Clinical data of patients who underwent TURBT at our institution between 2017 and 2021 were collected and retrospectively analysed. MLR was obtained from preoperative blood analyses performed within 1 month from hospital admission. The association of MLR with different clinic-pathological features obtained from histological reports was further analysed. Statistical analysis was performed using the Kruskal Wallis test for non-parametric variables, assuming p<0.05 as statistically significant. RESULTS 510 patients were included in the study (81% males, 19% females), with a mean age of 71.66 ± 11.64 years. Mean MLR was higher in patients with any-type bladder cancer, reporting an MLR of 0.41 ± 0.11 compared to 0.38 ± 0.43 in patients without bladder cancer (p=0.043). In the subsequent comparison among low-grade and high-grade bladder cancer, MLR did not report statistically significant differences, with 0.29 ± 0.12 for low-grade BC and 0.51 ± 0.81 for high-grade BC (p=0.085). CONCLUSIONS Our findings reported elevated preoperative MLR should be considered a potential biomarker predicting malignancy for bladder tumours. Furthermore, research are necessary to assess its role in discerning low-grade from high-grade patients.
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Affiliation(s)
- Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Pasquale Reccia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Luigi De Luca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Carmine Turco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Alberto Melchionna
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Vincenzo Morgera
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Giovanni Maria Fusco
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Benito Fabio Mirto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Giorgio Napodano
- Department of Urology, Ospedale del Mare, ASL Napoli 1 Centro, Naples, Italy
| | - Dario Del Biondo
- Department of Urology, Ospedale del Mare, ASL Napoli 1 Centro, Naples, Italy
| | - Domenico Prezioso
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
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