The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy

Background: This study aimed to assess the prognostic significance of pre-treatment lymphocyte-related systemic inflammatory biomarkers in upper tract urothelial carcinoma (UTUC) patients. Methods: This study included non-metastatic UTUC patients treated at our hospital between 2001 and 2013. The re...

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Autores principales:	Tsu-Ming Chien, Ching-Chia Li, Yen-Man Lu, Yii-Her Chou, Hsueh-Wei Chang, Wen-Jeng Wu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	upper tract urothelial carcinoma bladder recurrence survival platelet-lymphocyte neutrophile-lymphocyte systemic immune-inflammation index Medicine R
Acceso en línea:	https://doaj.org/article/8e1a403b1bf74723b8cb7a5d111ffbeb
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spelling	oai:doaj.org-article:8e1a403b1bf74723b8cb7a5d111ffbeb2021-11-25T18:01:11ZThe Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy10.3390/jcm102252732077-0383https://doaj.org/article/8e1a403b1bf74723b8cb7a5d111ffbeb2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5273https://doaj.org/toc/2077-0383Background: This study aimed to assess the prognostic significance of pre-treatment lymphocyte-related systemic inflammatory biomarkers in upper tract urothelial carcinoma (UTUC) patients. Methods: This study included non-metastatic UTUC patients treated at our hospital between 2001 and 2013. The receiver operating characteristic curve was used to obtain the optimal neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Multivariate logistic regression was performed to investigate the relationship between NLR, PLR, and SII and clinical pathologic characteristics. The Kaplan–Meier method was used to calculate the metastasis-free survival (MFS), cancer-specific survival (CSS), and bladder recurrence-free survival (BRFS), and the log-rank test was used to compare the survival rate. Results: Overall, 376 patients were included in the current study. An elevated SII was associated with symptomatic hydronephrosis, bladder cancer history, advanced pathologic tumor stage, lymph node invasion, adjuvant chemotherapy and concomitant carcinoma in situ (CIS); high NLR was associated with older age, symptomatic hydronephrosis, hemodialysis status, anemia, multifocal tumor, advanced pathologic tumor stage, and adjuvant chemotherapy; and high PLR was associated with older age, anemia, advanced pathologic tumor stage, and adjuvant chemotherapy. The Kaplan–Meier analysis indicated that patients exhibiting higher NLR, PLR, and SII showed significantly poor MFS and CSS rates. Only high SII showed significantly worse BRFS rates. Conclusions: The NLR, PLR, and SII were independent predictive factors for both MFS and CSS in UTUC patients. Among the factors, only elevated SII can predict bladder recurrence. Therefore, the patients might need close bladder monitoring during the follow-up.Tsu-Ming ChienChing-Chia LiYen-Man LuYii-Her ChouHsueh-Wei ChangWen-Jeng WuMDPI AGarticleupper tract urothelial carcinomabladder recurrencesurvivalplatelet-lymphocyteneutrophile-lymphocytesystemic immune-inflammation indexMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5273, p 5273 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	upper tract urothelial carcinoma bladder recurrence survival platelet-lymphocyte neutrophile-lymphocyte systemic immune-inflammation index Medicine R
spellingShingle	upper tract urothelial carcinoma bladder recurrence survival platelet-lymphocyte neutrophile-lymphocyte systemic immune-inflammation index Medicine R Tsu-Ming Chien Ching-Chia Li Yen-Man Lu Yii-Her Chou Hsueh-Wei Chang Wen-Jeng Wu The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy
description	Background: This study aimed to assess the prognostic significance of pre-treatment lymphocyte-related systemic inflammatory biomarkers in upper tract urothelial carcinoma (UTUC) patients. Methods: This study included non-metastatic UTUC patients treated at our hospital between 2001 and 2013. The receiver operating characteristic curve was used to obtain the optimal neutrophile-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Multivariate logistic regression was performed to investigate the relationship between NLR, PLR, and SII and clinical pathologic characteristics. The Kaplan–Meier method was used to calculate the metastasis-free survival (MFS), cancer-specific survival (CSS), and bladder recurrence-free survival (BRFS), and the log-rank test was used to compare the survival rate. Results: Overall, 376 patients were included in the current study. An elevated SII was associated with symptomatic hydronephrosis, bladder cancer history, advanced pathologic tumor stage, lymph node invasion, adjuvant chemotherapy and concomitant carcinoma in situ (CIS); high NLR was associated with older age, symptomatic hydronephrosis, hemodialysis status, anemia, multifocal tumor, advanced pathologic tumor stage, and adjuvant chemotherapy; and high PLR was associated with older age, anemia, advanced pathologic tumor stage, and adjuvant chemotherapy. The Kaplan–Meier analysis indicated that patients exhibiting higher NLR, PLR, and SII showed significantly poor MFS and CSS rates. Only high SII showed significantly worse BRFS rates. Conclusions: The NLR, PLR, and SII were independent predictive factors for both MFS and CSS in UTUC patients. Among the factors, only elevated SII can predict bladder recurrence. Therefore, the patients might need close bladder monitoring during the follow-up.
format	article
author	Tsu-Ming Chien Ching-Chia Li Yen-Man Lu Yii-Her Chou Hsueh-Wei Chang Wen-Jeng Wu
author_facet	Tsu-Ming Chien Ching-Chia Li Yen-Man Lu Yii-Her Chou Hsueh-Wei Chang Wen-Jeng Wu
author_sort	Tsu-Ming Chien
title	The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy
title_short	The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy
title_full	The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy
title_fullStr	The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy
title_full_unstemmed	The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy
title_sort	predictive value of systemic immune-inflammation index on bladder recurrence on upper tract urothelial carcinoma outcomes after radical nephroureterectomy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8e1a403b1bf74723b8cb7a5d111ffbeb
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The Predictive Value of Systemic Immune-Inflammation Index on Bladder Recurrence on Upper Tract Urothelial Carcinoma Outcomes after Radical Nephroureterectomy

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