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

Abstract

Background: 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 to compare the survival rate.Results: Overall, 376 patients were included in the current study. Multivariate analysis revealed that an elevated SII was associated with advanced pathologic tumor stage, lymph node invasion, and adjuvant chemotherapy; high NLR was associated with older age, 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.

Prognostic and clinicopathological significance of systemic immune-inflammation index in upper tract urothelial carcinoma: a meta-analysis of 3911 patients

“…After reviewing the title and abstract, articles that did not meet the criteria were eliminated, leaving 17 articles to be read in their entirety. Six studies were finally confirmed, including 3911 UTUC patients in seven cohorts (13)(14)(15)(16)(17)(18). Figure 1 depicts the process of retrieving information.…”

“…All the articles included in the study were published within the past 5 years and were retrospective in nature. Two of the studies (14, 18) had three cohorts in China, two (13,17) in Taiwan China, one (16) in Japan, and one (13) in Europe and the United States. Among the above six articles, there is one article in Chinese (18) and five in English (13)(14)(15)(16)(17).…”

“…Two of the studies (14, 18) had three cohorts in China, two (13,17) in Taiwan China, one (16) in Japan, and one (13) in Europe and the United States. Among the above six articles, there is one article in Chinese (18) and five in English (13)(14)(15)(16)(17). The total sample size for all studies was 3911, with included studies ranging from 103 to 2373.…”

“…The average age of the patients was above 65 years, with thresholds varying from 410.3 to 672.44. Among them, five cohorts examined the correlation between OS and SII (13)(14)(15)(16), while six cohorts analyzed the association between CSS and SII (13)(14)(15)(16)(17), and five cohorts investigated the link between RFS and SII (14,15,17,18). Every study that was included in the analysis was deemed to be of excellent quality, scoring 6 or above on the Newcastle-Ottawa Scale (Table 2).…”

Association of systemic immune-inflammation index with insulin resistance and prediabetes: a cross-sectional study

“…It accurately reflects the local immune response and systemic inflammatory status of body ( 11 ). Multiple studies have substantiated the prognostic value of SII in assessing outcomes for various cancer patients, encompassing bladder cancer ( 12 ), cervical cancer ( 11 ), non-small cell lung cancer ( 13 ), colorectal cancer ( 14 ), and gastric cancer ( 15 ). In recent years, SII has emerged as an indicator for detecting chronic inflammatory disease beyond tumors.…”