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Prognostic value of the systemic immune-inflammation index in non-muscle invasive bladder cancer

Abstract : Purpose We assessed the prognostic value of systemic immune-inflammation index (SII) to refine risk stratification of the heterogeneous spectrum of patients with non-muscle-invasive bladder cancer (NMIBC) Methods In this multi-institutional cohort, preoperative blood-based SII was retrospectively assessed in 1117 patients with NMIBC who underwent transurethral resection of bladder (TURB) between 1996 and 2007. The optimal cut-off value of SII was determined as 580 using the best Youden index. Cox regression analyses were performed. The concordance index (C-index) and decision curve analysis (DCA) were used to assess the discrimination of the predictive models. Results Overall, 309 (28%) patients had high SII. On multivariable analyses, high SII was significantly associated with worse PFS (hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.23-2.77; P = 0.003) and CSS (HR 2.53; 95% CI 1.42-4.48; P = 0.001). Subgroup analyses, according to the European Association of Urology guidelines, demonstrated the main prognostic impact of high SII, with regards to PFS (HR 3.39; 95%CI 1.57-7.31; P = 0.002) and CSS (HR 4.93; 95% CI 1.70-14.3; P = 0.005), in patients with intermediate-risk group; addition of SII to the standard predictive model improved its discrimination ability both on C-index (6% and 12%, respectively) and DCA. In exploratory intergroup analyses of patients with intermediate-risk, the improved discrimination ability was retained the prediction of PFS and CSS. Conclusion Preoperative SII seems to identify NMIBC patients who have a worse disease and prognosis. Such easily available and cheap standard biomarkers may help refine the decision-making process regarding adjuvant treatment in patients with intermediate-risk NMIBC.
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https://hal.archives-ouvertes.fr/hal-03285200
Contributor : Laurent Jonchère Connect in order to contact the contributor
Submitted on : Tuesday, July 13, 2021 - 10:50:38 AM
Last modification on : Wednesday, November 10, 2021 - 5:38:05 PM
Long-term archiving on: : Thursday, October 14, 2021 - 6:47:33 PM

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Satoshi Katayama, Keiichiro Mori, Benjamin Pradere, Ekaterina Laukhtina, Victor M. Schuettfort, et al.. Prognostic value of the systemic immune-inflammation index in non-muscle invasive bladder cancer. World Journal of Urology, Springer Verlag, 2021, ⟨10.1007/s00345-021-03740-3⟩. ⟨hal-03285200⟩

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