Systemic Inflammatory Markers and Oncologic Outcomes in Patients with High-risk Non–muscle-invasive Urothelial Bladder Cancer

Cantiello, Francesco; Russo, Giorgio Ivan; Vartolomei, Mihai Dorin; Farhan, Abdal Rahman Abu; Terracciano, Daniela; Musi, Gennaro; Lucarelli, Giuseppe; Stasi, Savino M. Di; Hurle, Rodolfo; Serretta, Vincenzo; Busetto, Gian Maria; Scafuro, Chiara; Perdonà, Sisto; Borghesi, Marco; Schiavina, Riccardo; Cioffi, Antonio; Berardinis, Ettore De; Almeida, Gilberto Laurino; Bove, Pierluigi; Lima, Estêvão; Ucciero, Giuseppe; Matei, Deliu Victor; Crişan, Nicolae; Verze, Paolo; Battaglia, Michele; Guazzoni, Giorgio; Autorino, Riccardo; Morgia, Giuseppe; Damiano, Rocco; Cobelli, O. De; Mirone, Vincenzo; Shariat, Shahrokh F.; Ferro, Matteo

doi:10.1016/j.euo.2018.06.006

Cited by 70 publications

(78 citation statements)

References 18 publications

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“…Another anti-IL-6, tocilizumab, commonly used for rheumatoid arthritis, offers promising results for treating cancer, particularly when combined with conventional drugs. Another association that may be helpful to improve immunotherapy of cancer is the link between IL-6-blocking agents and epidermal growth factor receptor inhibitors or other targeted therapy [47,52,[54][55][56][57][58][59][60][61][62]64]. Therefore, the IL-6-signaling pathway represents an attractive target for therapeutic or preventive interventions, not only for cancer, but even for infectious diseases and chronic inflammatory diseases.…”

Section: Resultsmentioning

confidence: 99%

SARS-CoV-2 Infection and High-Risk Non-Muscle-Invasive Bladder Cancer: Are There Any Common Features?

et al. 2020

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Background: The new severe acute respiratory syndrome virus (SARS-CoV-2) outbreak is a huge health, social and economic issue and has been declared a pandemic by the World Health Organization. Bladder cancer, on the contrary, is a well-known disease burdened by a high rate of affected patients and risk of recurrence, progression and death. Summary: The coronavirus disease (COVID-19 or 2019-nCoV) often involves mild clinical symptoms but in some cases, it can lead to pneumonia with acute respiratory distress syndrome and multiorgan dysfunction. Factors associated with developing a more severe disease are increased age, obesity, smoking and chronic underlying comorbidities (including diabetes mellitus). High-risk non-muscle-invasive bladder cancer (NMIBC) progression and worse prognosis are also characterized by a higher incidence in patients with risk factors similar to COVID-19. Immune system response and inflammation have been found as a common hallmark of both diseases. Most severe cases of COVID-19 and highrisk NMIBC patients at higher recurrence and progression risk are characterized by innate and adaptive immune activation followed by inflammation and cytokine/chemokine storm (interleukin [IL]-2, IL-6, IL-8). Alterations in neutrophils, lymphocytes and platelets accompany the systemic inflammatory response to cancer and infections. Neutrophil-tolymphocyte ratio and platelet-to-lymphocyte ratio for example have been recognized as factors related to poor progno

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Section: Resultsmentioning

confidence: 99%

SARS-CoV-2 Infection and High-Risk Non-Muscle-Invasive Bladder Cancer: Are There Any Common Features?

et al. 2020

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“…Based on a similar concept as AGR (i.e. use of a ratio), several systemic inflammatory markers, such as the neutrophil-to-lymphocyte ratio [11,12,28], platelet-to-lymphocyte ratio [28], and lymphocyte-to- Fig. 3 Kaplan-Meier curves depicting OS a in patients with AGR < 1.25 versus ≥1.25 (P < 0.01, log-rank test).…”

Section: Discussionmentioning

confidence: 99%

“…3 Kaplan-Meier curves depicting OS a in patients with AGR < 1.25 versus ≥1.25 (P < 0.01, log-rank test). Abbreviations: AGR = albumin-toglobulin ratio; OS = overall survival Abbreviations: HR hazard ratio, CI confidence interval, AGR albumin-to-globulin ratio *Statistically significant monocyte ratio [28], have been established and wellinvestigated in the field of oncology, including urothelial carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of the albumin-to-globulin ratio for upper tract urothelial carcinoma

et al. 2020

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Background: Although the albumin-to-globulin ratio (AGR) is a promising biomarker for various malignancies, few studies have investigated its prognostic significance for upper tract urothelial carcinoma (UTUC). Methods: This retrospective study conformed to the REporting recommendations for tumour MARKer prognostic studies (REMARK) guideline. We reviewed 179 patients with UTUC who underwent radical nephroureterectomy at our institution between 2008 and 2018. Associations of preoperative clinicopathological factors, including the AGR, with cancer-specific survival (CSS) and overall survival (OS) were assessed. The Cox proportional hazards model was used for univariate and multivariable analyses. AGR was dichotomized as < 1.25 and ≥ 1.25, according to the most discriminatory cutoff determined from the receiver operating characteristic curve analysis. Results: During a median follow-up of 34 months after surgery, 37 patients died from UTUC and 13 died of other causes. The preoperative AGR significantly correlated with pathological T stage, pathological N stage, and adjuvant chemotherapy. Multivariate analyses demonstrated that a decreased (< 1.25) preoperative AGR was an independent poor prognostic factor for both CSS (hazard ratio [HR] = 2.81, P < 0.01) and OS (HR = 2.09, P < 0.05). Conclusions: Preoperative AGR < 1.25 might serve as a useful prognostic marker for patients with UTUC undergoing radical nephroureterectomy.

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“…There are recent studies on the relationship between systemic inflammation markers and cancer outcomes 33 . Systemic inflammatory status is also suggested as a possible predictor of diabetes, obesity, and cancer.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of bladder cancer with metabolically unhealthy status: analysis from the National Health Checkup database in Korea

Kim

Ahn

et al. 2020

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We assessed the association between metabolic health status and the incidence of bladder cancer using nationally representative data from the national Health insurance System and national Health Checkups (NHC) databases in South Korea. Data for 11,781,768 men who participated in the NHC between 2009 and 2012 were analysed. The normal-weight and physically obese categories were defined as body mass indexes (BMI) < 25 and ≥25 kg/m 2 , respectively. Metabolically obese was defined as the presence of ≥3 components of metabolic syndrome. The participants were stratified into metabolically healthy, normal-weight (MHNW); metabolically obese, normal-weight (MONW); metabolically healthy, obese (MHO); metabolically obese, obese (MOO). Multivariate-adjusted Cox regression analysis was conducted to examine the association between metabolic health status and the incidence of bladder cancer. The study participants included 17,777 men newly registered with bladder cancer. Analysis according to metabolic health status classification revealed a higher multivariableadjusted hazard ratio in the MOO, MONW group than in the MHO group (1.307 [95% CI: 1.258-1.358], 1.183 [95% CI: 1.137-1.231] and 1.066 [95% CI: 1.017-1.119], respectively; hazard ratios given relative to MHnW group) We found an association between metabolic health status and the incidence of bladder cancer, with an increasing risk according to the number of metabolic health status components. Data source and study population. InSouth Korea, the National Health Insurance System (NHIS) established in 2000 covers about 98% of the citizens (about 50 million in 2014) 15 . All insurance members and dependents are asked to undergo a free biannual health check-up as part of the NHIS. In 2013, about 68% of members received a full health check-up 16 , making it possible to obtain information on population-wide disease status 17 .In the present study, sex, birth date, past history, medication history, socioeconomic data, body size phenotypes, and diagnostic codes based on the International Statistical Classification of Diseases and related health problems 10th revision, Clinical Modification (ICD-10-CM) were retrieved.Data from a total of 11,781,768 men who participated in the National Health Checkups (NHC) program between January 2009 and December 2012 were analysed. Body size phenotypes were classified according to BMI, which was calculated from measured height and weight, and the presence or absence of metabolic syndrome according to the results of the NHC 17 .Since patients that are diagnosed with cancer, cardiovascular disease, cerebrovascular disease, and rare disease are entitled to economic benefits from the Korean government 18 , almost all physician-diagnosed cancer patients are registered in the central database 19 . Bladder cancer was coded as C67 in the ICD-10-CM. A flowchart for the selection of the study participants is shown in Fig. 1. Definition of metabolic health status. 'Physically obese' was categorized according to the World HealthOrganization's (WHO) definit...

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Systemic Inflammatory Markers and Oncologic Outcomes in Patients with High-risk Non–muscle-invasive Urothelial Bladder Cancer

Cited by 70 publications

References 18 publications

SARS-CoV-2 Infection and High-Risk Non-Muscle-Invasive Bladder Cancer: Are There Any Common Features?

SARS-CoV-2 Infection and High-Risk Non-Muscle-Invasive Bladder Cancer: Are There Any Common Features?

Prognostic significance of the albumin-to-globulin ratio for upper tract urothelial carcinoma

Increased incidence of bladder cancer with metabolically unhealthy status: analysis from the National Health Checkup database in Korea

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