Kayar Ridvan, Bastug Yavuz, Tokuc Emre, Topaktas Ramazan, Akyurek Elif Atag, Kayar Kemal, Artuk Ilker, Ozturk Metin
Department of Urology, University of Health Sciences, Haydarpasa Numune SUAM, Tıbbiye Str. No: 40, Uskudar, Istanbul, Turkey.
Faculty of Medicine, Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkey.
Int Urol Nephrol. 2024 Feb;56(2):509-518. doi: 10.1007/s11255-023-03812-w. Epub 2023 Sep 29.
To evaluate the association between preoperative pan-immune inflammation value (PIV) and overall survival (OS) and disease-free survival (DFS) in patients who underwent radical cystectomy for non-metastatic muscle-invasive bladder cancer.
A total of 119 patients with non-metastatic muscle-invasive bladder cancer who underwent radical cystectomy at our institution between January 2014 and January 2022 were included in this retrospective study. PIV was calculated using the formula (monocyte count × neutrophil count × platelet count)/lymphocyte count. Ideal cut-off values for PIV were determined using ROC curve analysis. Kaplan-Meier analysis was used to evaluate the impact of PIV on survival outcomes.
The mean age of patients was 65 ± 14 years, and the mean follow-up duration was 36 months. The ideal cutoff value for PIV was determined to be 406.29, and a PIV above this value was associated with poorer OS (p < 0.001) (73 months vs. 21 months) and DFS (p = 0.002) (35 months vs 19 months). Higher neutrophil-to-lymphocyte ratio (NLR) values were also associated with poorer OS (p < 0.001) and DFS (p < 0.001), with similar effectiveness to PIV. PIV was found to be significantly more effective than platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) in predicting DFS.
Preoperative PIV may serve as an independent prognostic factor for OS in patients who undergo radical cystectomy with non-metastatic muscle-invasive bladder cancer. A high PIV value was associated with poorer survival outcomes. Prospective multicenter studies are needed to further validate the relationship between PIV and histopathological features of bladder cancer.
评估接受根治性膀胱切除术的非转移性肌层浸润性膀胱癌患者术前全免疫炎症值（PIV）与总生存期（OS）和无病生存期（DFS）之间的关联。
本回顾性研究纳入了2014年1月至2022年1月期间在我院接受根治性膀胱切除术的119例非转移性肌层浸润性膀胱癌患者。使用公式（单核细胞计数×中性粒细胞计数×血小板计数）/淋巴细胞计数计算PIV。使用受试者工作特征（ROC）曲线分析确定PIV的理想临界值。采用Kaplan-Meier分析评估PIV对生存结局的影响。
患者的平均年龄为65±14岁，平均随访时间为36个月。确定PIV的理想临界值为406.29，高于该值的PIV与较差的OS（p<0.001）（73个月对21个月）和DFS（p=0.002）（35个月对19个月）相关。较高的中性粒细胞与淋巴细胞比值（NLR）也与较差的OS（p<0.001）和DFS（p<0.001）相关，其有效性与PIV相似。发现PIV在预测DFS方面比血小板与淋巴细胞比值（PLR）和全身免疫炎症指数（SII）显著更有效。
术前PIV可能是接受根治性膀胱切除术的非转移性肌层浸润性膀胱癌患者OS的独立预后因素。高PIV值与较差的生存结局相关。需要进行前瞻性多中心研究以进一步验证PIV与膀胱癌组织病理学特征之间的关系。
