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Russo P, Palermo G, Iacovelli R, Ragonese M, Ciccarese C, Maioriello G, Fantasia F, Bizzarri FP, Marino F, Moosavi K, Nigro D, Filomena GB, Gavi F, Rossi F, Pinto F, Racioppi M, Foschi N. Comparison of PIV and Other Immune Inflammation Markers of Oncological and Survival Outcomes in Patients Undergoing Radical Cystectomy. Cancers (Basel) 2024; 16:651. [PMID: 38339402 PMCID: PMC10854772 DOI: 10.3390/cancers16030651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Inflammation is widely acknowledged as a significant characteristic of cancer, playing a substantial function in both the initiation and advancement of cancers. In this research, we planned to compare pan-immune inflammation markers and other well-known markers (systemic immune inflammation index and neutrophil to lymphocyte ratio) to predict prognosis in individuals treated with radical cystectomy for bladder cancer. METHODS In this retrospective analysis, we focused on preoperative PIV, systemic immune inflammation index (SII), and neutrophil-lymphocyte ratio (NLR) in 193 individuals managed with radical cystectomy for bladder cancer between January 2016 and November 2022. Multivariable logistic regression assessments were performed to assess the predictive capabilities of PIV, SII, and NLR for infiltration of lymph nodes (N), aggressive tumor stage (pT3/pT4), and any non-organ limited disease at the time of RC. Multivariable Cox regression analyses were conducted to assess the predictive impact of PIV on Relapse-free survival (RFS), Cancer-specific survival (CSS), and Overall survival (OS). RESULTS Our individuals were divided into high PIV and low PIV cohorts using the optimal cut-off value (340.96 × 109/L) based on receiver operating characteristic curve analysis for relapse-free survival. In multivariable preoperative logistic regression models, only SII and PIV correlated with the infiltration of lymph nodes, aggressive disease, and any non-organ confined disease. In multivariable Cox regression models considering presurgical clinicopathological variables, a higher PIV was associated with diminished RFS (p = 0.017) and OS (p = 0.029). In addition, in multivariable Cox regression models for postoperative outcomes, a high PIV correlated with both RFS (p = 0.034) and OS (p = 0.048). CONCLUSIONS Our study suggests that PIV and SII are two very similar markers that may serve as independent and significant predictors of aggressive disease and worse survival impacts on individuals undergoing radical cystectomy for bladder neoplasm.
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Affiliation(s)
- Pierluigi Russo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Giuseppe Palermo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Roberto Iacovelli
- Department of Oncology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (R.I.); (C.C.)
| | - Mauro Ragonese
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Chiara Ciccarese
- Department of Oncology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (R.I.); (C.C.)
| | - Giuseppe Maioriello
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Fabrizio Fantasia
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Francesco Pio Bizzarri
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Filippo Marino
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Koosha Moosavi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Domenico Nigro
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Giovanni Battista Filomena
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Filippo Gavi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Francesco Rossi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Francesco Pinto
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Marco Racioppi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
| | - Nazario Foschi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy; (P.R.); (M.R.); (G.M.); (F.F.); (F.P.B.); (F.M.); (K.M.); (D.N.); (G.B.F.); (F.G.); (F.R.); (F.P.); (M.R.); (N.F.)
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Kayar R, Bastug Y, Tokuc E, Topaktas R, Akyurek EA, Kayar K, Artuk I, Ozturk M. Pan-immune-inflammation value as a prognostic tool for overall survival and disease-free survival in non-metastatic muscle-invasive bladder cancer. Int Urol Nephrol 2024; 56:509-518. [PMID: 37773579 DOI: 10.1007/s11255-023-03812-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/14/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE To evaluate the association between preoperative pan-immune inflammation value (PIV) and overall survival (OS) and disease-free survival (DFS) in patients who underwent radical cystectomy for non-metastatic muscle-invasive bladder cancer. METHODS A total of 119 patients with non-metastatic muscle-invasive bladder cancer who underwent radical cystectomy at our institution between January 2014 and January 2022 were included in this retrospective study. PIV was calculated using the formula (monocyte count × neutrophil count × platelet count)/lymphocyte count. Ideal cut-off values for PIV were determined using ROC curve analysis. Kaplan-Meier analysis was used to evaluate the impact of PIV on survival outcomes. RESULTS The mean age of patients was 65 ± 14 years, and the mean follow-up duration was 36 months. The ideal cutoff value for PIV was determined to be 406.29, and a PIV above this value was associated with poorer OS (p < 0.001) (73 months vs. 21 months) and DFS (p = 0.002) (35 months vs 19 months). Higher neutrophil-to-lymphocyte ratio (NLR) values were also associated with poorer OS (p < 0.001) and DFS (p < 0.001), with similar effectiveness to PIV. PIV was found to be significantly more effective than platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) in predicting DFS. CONCLUSION Preoperative PIV may serve as an independent prognostic factor for OS in patients who undergo radical cystectomy with non-metastatic muscle-invasive bladder cancer. A high PIV value was associated with poorer survival outcomes. Prospective multicenter studies are needed to further validate the relationship between PIV and histopathological features of bladder cancer.
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Affiliation(s)
- Ridvan Kayar
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Yavuz Bastug
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Emre Tokuc
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey.
| | - Ramazan Topaktas
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Elif Atag Akyurek
- Faculty of Medicine, Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkey
| | - Kemal Kayar
- Urology Clinic, Kilis Prof.Dr. Alaeddin Yavasca State Hospital, Kilis, Turkey
| | - Ilker Artuk
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
| | - Metin Ozturk
- Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey
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Zheng J, Peng L, Zhang S, Liao H, Hao J, Wu S, Shen H. Preoperative systemic immune-inflammation index as a prognostic indicator for patients with urothelial carcinoma. Front Immunol 2023; 14:1275033. [PMID: 38053997 PMCID: PMC10694229 DOI: 10.3389/fimmu.2023.1275033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Background The systemic immune-inflammation index (SII) is a cost-efficient indicator for carcinoma prognosis. However, its utility in urothelial carcinoma (UC) prognosis is disputed. This meta-analysis aims to assess SII's prognostic value in UC. Methods A thorough search of databases including PubMed, Web of Science, Embase, Cochrane Library, and Scopus, was conducted to find studies until January 11, 2023. Eligibility criteria were applied to select studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted from selected studies and compiled in a meta-analysis to gauge SII's association with survival outcomes such as overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and progression-free survival (PFS). Results This analysis includes 19 studies with 12505 UC patients. It was found that high SII significantly correlated with worse OS in UC patients (HR 1.430, 95% CI 1.237-1.653, P<0.001). High SII values also linked with poorer CSS (HR 1.913, 95% CI 1.473-2.485, P<0.001), RFS (HR 1.240, 95% CI 1.097-1.403, P=0.001), and PFS (HR 1.844, 95% CI 1.488-2.284, P<0.001) compared to low SII values. Subgroup analysis revealed SII's consistent prognostic value in UC across races, carcinoma types, sample sizes, and SII cut-off values, suggesting its potential as a prognostic indicator in UC patients. Conclusion Current evidence suggests SII as a promising, cost-efficient predictor in UC patients. This meta-analysis indicates SII's potential as a valuable prognostic tool in UC patients. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=307643, identifier CRD42022307643.
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Affiliation(s)
- Jianxiong Zheng
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Rheumatology and Immunology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Lei Peng
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
- South China Hospital, Health Science Center, Shenzhen University, Shenzhen, China
| | - Shaohua Zhang
- South China Hospital, Health Science Center, Shenzhen University, Shenzhen, China
| | - Haiyang Liao
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Jiayao Hao
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
| | - Song Wu
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
- South China Hospital, Health Science Center, Shenzhen University, Shenzhen, China
| | - Haili Shen
- The Second Clinical Medical College, Lanzhou University, Lanzhou, China
- Department of Rheumatology and Immunology, Second Hospital of Lanzhou University, Lanzhou, China
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