• Int. J. Clin. Pract. · Apr 2021

    Can the systemic immune inflammation index be a predictor of bcg response in patients with high-risk non-muscle invasive bladder cancer?

    • Serkan Akan, Caner Ediz, Aytac Sahin, Hasan Huseyin Tavukcu, Ahmet Urkmez, Alper Horasan, Omer Yilmaz, and Ayhan Verit.
    • Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
    • Int. J. Clin. Pract. 2021 Apr 1; 75 (4): e13813.

    AimWe aimed to investigate the predictor role of the systemic immune-inflammation index (SII) on Bacille Calmette-Guerin (BCG) response in patients with high-risk non-muscle invasive bladder cancer (NMIBC).MethodsA total of 96 patients with high-risk NMIBC, who received intravesical BCG, were enrolled in the study. BCG responsive group (group 1) and BCG failure group (group 2) were compared in terms of demographic and pathological data, peripheral lymphocyte, neutrophil and platelet counts, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence-free survival (RFS) and progression-free survival (PFS). The SII was calculated as in the formula: SII = neutrophil × platelet/lymphocyte. The prognostic ability of the SII for progression was analysed with multivariate backward stepwise regression models.ResultsThe mean follow-up time 34.635 ± 14.7 months. Group 2 had significantly higher SII, peripheral lymphocyte, neutrophil and platelet counts than group 1. An ROC curve was plotted for the SII to predict the BCG failure and the cut-off point was calculated as 672.75. Effect of the SII to the model was statistically significant (P = .003) and a higher SII increased the progression onefold. A tumour greater than 30 mm in size and a high SII together increased the progression 3.6 folds.ConclusionsThe SII might be a successful, non-invasive and low-cost parameter for prediction of BCG failure in patients with high-risk NMIBC. The cut-off value for SII is 672.75 and above this level BCG failure and progression to MIBC might be anticipated. However, these results should be validated in prospective randomised controlled studies with large patient groups.© 2020 John Wiley & Sons Ltd.

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