The systemic inflammation response index: An independent predictive factor for survival outcomes of bladder cancer stronger than other inflammatory markers.
Autor: | Yilmaz H; Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey., Cinar NB; Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey. Electronic address: n.burak.cinar@gmail.com., Avci IE; Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey., Telli E; Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey., Uslubas AK; Department of Urology, Derince Training and Research Hospital, Kocaeli, Turkey., Teke K; Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey., Dillioglugil O; Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey. |
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Jazyk: | angličtina |
Zdroj: | Urologic oncology [Urol Oncol] 2023 May; Vol. 41 (5), pp. 256.e1-256.e8. Date of Electronic Publication: 2022 Dec 26. |
DOI: | 10.1016/j.urolonc.2022.11.011 |
Abstrakt: | Purpose: We aimed to evaluate the prognostic value of the preoperative systemic inflammation response index (SIRI) to predict the outcomes after open radical cystectomy (RC). Materials and Methods: We conducted a retrospective analysis of the institutional cystectomy database and identified 241 consecutive RC patients. Patient demographics and oncologic outcomes were noted. We calculated the SIRI as previously described (NeutrophilxMonocytes/Lymphocytes), based on the blood-tests at the day before surgery and a minimum >30-day later. Results: Median follow-up time was 20 months (interquartile range 9-52). Two, 3 and 5 years recurrence free (RFS) and overall survival (OS) rates were 60.6%, 57.1%, 48.9%, and 54.7%, 47.0%, 37.2%, respectively. Patients with preoperative SIRI >1.91 had significantly higher recurrence rates (P < 0.001) and lower OS (P < 0.001). For internal validation, we evaluated postoperative SIRI >1.91 (repeatability testing), and again found significantly higher recurrence rates (P < 0.001) and lower OS (P = 0.004). Persistently high SIRI increased the recurrence and death risk 5.79 and 2.87 fold, respectively. SIRI was also a significant independent predictive factor for RFS and OS in the multivariable cox regression analyses (P < 0.05). SIRI improved the discriminative ability of the models 1.5% to 4.2% and this was quite higher than other inflammatory markers (NLR, MLR, PLR, SII) in all models. Conclusions: Patients with SIRI >1.91 had significantly higher recurrence and lower OS rates. The cut-off value is validated internally. SIRI is an independent predictive factor for RFS and OS. The contribution of SIRI in the cox models is higher than other inflammatory markers. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
Databáze: | MEDLINE |
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