Predictive Role of the Systemic Immune Inflammation Index for Intravesical BCG Response in Intermediate- and High-Risk Non-Muscle-Invasive Bladder Cancer

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dc.contributor.authorBolat, Deniz
dc.contributor.authorBaltacı, Sümer
dc.contributor.authorAkgül, Murat
dc.contributor.authorKarabay, Emre
dc.contributor.authorİzol, Volkan
dc.contributor.authorAslan, Güven
dc.contributor.authorEskiçorapçı, Saadettin
dc.date.accessioned2023-05-06T17:22:12Z
dc.date.available2023-05-06T17:22:12Z
dc.date.issued2023
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Acil Tıp Ana Bilim Dalı
dc.description.abstractIntroduction: In this study, we aimed to explore using the predictive role of systemic immune inflammation index (SII) for responses of intravesical Bacillus Calmette-Guerin (BCG) therapy in patients with intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC). Methods: From 9 centers, we reviewed the data of patients treated for intermediate- and high-risk NMIBC between 2011 and 2021. All patients enrolled in the study presented with T1 and/or high-grade tumors on initial TURB had undergone re-TURB within 4-6 weeks after initial TURB and had received at least a 6-week course of intravesical BCG induction. SII was calculated with the formula SII = (P x N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. In patients with intermediate- and high-risk NMIBC, the clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices. These included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-neutrophil ratio (PNR), and platelet-to-lymphocyte ratio (PLR). Results: A total of 269 patients were enrolled in the study. Median follow-up time was 39 months. Disease recurrence and progression were observed in 71 (26.4%) and 19 (7.1%) patients, respectively. For groups with and without disease recurrence in terms of NLR, PLR, PNR, and SII calculated prior to intravesical BCG treatment, no statistically significant differences were observed (p = 0.470, p = 0.247, p = 0.495, and p = 0.243, respectively). Moreover, there were also no statistically significant differences between the groups with and without disease progression in terms of NLR, PLR, PNR, and SII (p = 0.504, p = 0.165, p = 0.410, and p = 0.242, respectively). SII did not show any statistically significant difference between early (<6 months) and late (>= 6 months) recurrence (p = 0.492) and progression groups (p = 0.216). Conclusion: For patients with intermediate- and high-risk NMIBC, serum SII levels do not present as an appropriate biomarker for the prediction of disease recurrence and progression following intravesical BCG therapy. A possible explanation for the failure of SII to predict BCG response may be found in the impact of Turkey's nationwide tuberculosis vaccination program.
dc.identifier.doi10.1159/000528740
dc.identifier.issn0042-1138
dc.identifier.issn1423-0399
dc.identifier.pmid36809748
dc.identifier.scopus2-s2.0-85149151875
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.1159/000528740
dc.identifier.urihttps://hdl.handle.net/20.500.11776/12113
dc.identifier.wosWOS:000935270200001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorŞahin, Hayrettin
dc.language.isoen
dc.publisherKarger
dc.relation.ispartofUrologia Internationalis
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectIntravesical BCG
dc.subjectBladder cancer
dc.subjectPrognosis
dc.subjectSystemic immune inflammation index
dc.subjectBiomarker
dc.subjectInflammation
dc.subjectBacillus-Calmette-Guerin
dc.subjectSurvival
dc.subjectProgression
dc.subjectImmunotherapy
dc.titlePredictive Role of the Systemic Immune Inflammation Index for Intravesical BCG Response in Intermediate- and High-Risk Non-Muscle-Invasive Bladder Cancer
dc.typeArticle

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