Yu Lian-Ching, Wang Chu-An, Hu Che-Yuan, Lin Kun-Che, Ou Chien-Hui, Jan Hau-Chern
Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan, R.O.C.
Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan, R.O.C.
Oncol Lett. 2024 Jul 15;28(3):436. doi: 10.3892/ol.2024.14569. eCollection 2024 Sep.
In cancer, tumor-related inflammation affects disease progression and survival outcomes. However, the role of systemic inflammation in tumor multifocality in upper tract urothelial carcinoma (UTUC) is not well understood. The aim of the present study was to evaluate the impact of the systemic inflammation response index (SIRI) on tumor multifocality for predicting oncological outcomes in patients with UTUC after radical nephroureterectomy (RNU). For this purpose, data from 645 patients with non-metastatic UTUC who underwent RNU between 2008 and 2020 were retrospectively analyzed. Survival outcomes such as overall survival (OS), cancer-specific survival (CSS) and recurrence-free survival (RFS) RATES were assessed using the Kaplan-Meier method, and independent prognostic factors were identified through a multivariable Cox proportional hazards regression model. Of the 645 patients with UTUC included in the present study, 163 (25%) had multifocal UTUC. Kaplan-Meier analysis indicated that multifocal UTUC synchronous with a high-level SIRI was significantly associated with poorer outcomes after RNU. Furthermore, the results of the multivariate Cox proportional hazards model analysis demonstrated that multifocal tumor coupled with a high-level SIRI was an independent factor for predicting a shorter survival and disease progression. In conclusion, the results of the present study indicated that an elevated SIRI significantly influenced the survival rate of patients with multifocal UTUC. Specifically, integrating multifocal UTUC with a high-level SIRI emerged as an independent risk factor for poorer OS, CSS and RFS. These findings highlighted the potential role of SIRI in the risk stratification and management of patients with multifocal UTUC.
在癌症中，肿瘤相关炎症会影响疾病进展和生存结果。然而，全身炎症在上尿路尿路上皮癌（UTUC）肿瘤多灶性中的作用尚未完全明确。本研究的目的是评估全身炎症反应指数（SIRI）对肿瘤多灶性的影响，以预测根治性肾输尿管切除术（RNU）后UTUC患者的肿瘤学结局。为此，对2008年至2020年间接受RNU的645例非转移性UTUC患者的数据进行了回顾性分析。采用Kaplan-Meier法评估总生存（OS）、癌症特异性生存（CSS）和无复发生存（RFS）率等生存结局，并通过多变量Cox比例风险回归模型确定独立预后因素。本研究纳入的645例UTUC患者中，163例（25%）患有多灶性UTUC。Kaplan-Meier分析表明，与高水平SIRI同步的多灶性UTUC与RNU后较差的结局显著相关。此外，多变量Cox比例风险模型分析结果显示，多灶性肿瘤合并高水平SIRI是预测生存期缩短和疾病进展的独立因素。总之，本研究结果表明，SIRI升高显著影响多灶性UTUC患者的生存率。具体而言，多灶性UTUC合并高水平SIRI是OS、CSS和RFS较差的独立危险因素。这些发现突出了SIRI在多灶性UTUC患者风险分层和管理中的潜在作用。
