Prognostic significance of markers of systemic inflammatory response in patients with non-muscle-invasive bladder cancer
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Prognostic significance of markers of systemic inflammatory response in patients with non-muscle-invasive bladder cancer. / Mbeutcha, Aurélie; Shariat, Shahrokh F; Rieken, Malte; Rink, Michael; Xylinas, Evanguelos; Seitz, Christian; Lucca, Ilaria; Mathieu, Romain; Rouprêt, Morgan; Briganti, Alberto; Karakiewicz, Pierre I; Klatte, Tobias.
In: UROL ONCOL-SEMIN ORI, Vol. 34, No. 11, 16.09.2016, p. 483.e17-483.e24.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Prognostic significance of markers of systemic inflammatory response in patients with non-muscle-invasive bladder cancer
AU - Mbeutcha, Aurélie
AU - Shariat, Shahrokh F
AU - Rieken, Malte
AU - Rink, Michael
AU - Xylinas, Evanguelos
AU - Seitz, Christian
AU - Lucca, Ilaria
AU - Mathieu, Romain
AU - Rouprêt, Morgan
AU - Briganti, Alberto
AU - Karakiewicz, Pierre I
AU - Klatte, Tobias
N1 - Copyright © 2016. Published by Elsevier Inc.
PY - 2016/9/16
Y1 - 2016/9/16
N2 - BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) and the C-reactive protein (CRP) are markers of systemic inflammatory response, which have been associated with the prognosis of multiple malignancies, but their relationships with oncologic outcomes of non-muscle-invasive bladder cancer (NMIBC) have not been well studied yet.PATIENTS AND METHODS: We retrospectively reviewed the medical records of 1,117 patients with NMIBC who underwent a transurethral resection of the bladder. Univariable and multivariable competing risk regression models were used to assess the association of preoperative NLR and CRP with disease recurrence and progression to muscle-invasive disease. The median follow-up was 64 months.RESULTS: In total, 360 patients (32.2%) had a high NLR (≥2.5) and 145 (13.0%) had a high CRP (≥5mg/l). On multivariable analyses, a high NLR was associated with both disease recurrence (subhazard ratio [SHR] = 1.27, P = 0.013) and progression (SHR = 1.72, P = 0.007), and high CRP was associated with disease progression (SHR = 1.72, P = 0.031). Adding NLR and CRP to the multivariable model predicting disease progression lead to a relevant change in discrimination (+2.0%). In a subgroup analysis of 300 patients treated with bacillus Calmette-Guerin, both high NLR and high CRP were associated with disease progression (SHR = 2.80, P = 0.026 and SHR = 3.51, P = 0.021, respectively), and NLR was associated with disease recurrence (SHR = 1.46, P = 0.046). There was also an increase in the discrimination of the model predicting progression after bacillus Calmette-Guerin following the inclusion of both markers (+2.4%).CONCLUSION: In patients with NMIBC, markers of systemic inflammation response are associated with disease recurrence and progression. The inclusion of such markers in prognostic models does enhance their accuracy.
AB - BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) and the C-reactive protein (CRP) are markers of systemic inflammatory response, which have been associated with the prognosis of multiple malignancies, but their relationships with oncologic outcomes of non-muscle-invasive bladder cancer (NMIBC) have not been well studied yet.PATIENTS AND METHODS: We retrospectively reviewed the medical records of 1,117 patients with NMIBC who underwent a transurethral resection of the bladder. Univariable and multivariable competing risk regression models were used to assess the association of preoperative NLR and CRP with disease recurrence and progression to muscle-invasive disease. The median follow-up was 64 months.RESULTS: In total, 360 patients (32.2%) had a high NLR (≥2.5) and 145 (13.0%) had a high CRP (≥5mg/l). On multivariable analyses, a high NLR was associated with both disease recurrence (subhazard ratio [SHR] = 1.27, P = 0.013) and progression (SHR = 1.72, P = 0.007), and high CRP was associated with disease progression (SHR = 1.72, P = 0.031). Adding NLR and CRP to the multivariable model predicting disease progression lead to a relevant change in discrimination (+2.0%). In a subgroup analysis of 300 patients treated with bacillus Calmette-Guerin, both high NLR and high CRP were associated with disease progression (SHR = 2.80, P = 0.026 and SHR = 3.51, P = 0.021, respectively), and NLR was associated with disease recurrence (SHR = 1.46, P = 0.046). There was also an increase in the discrimination of the model predicting progression after bacillus Calmette-Guerin following the inclusion of both markers (+2.4%).CONCLUSION: In patients with NMIBC, markers of systemic inflammation response are associated with disease recurrence and progression. The inclusion of such markers in prognostic models does enhance their accuracy.
U2 - 10.1016/j.urolonc.2016.05.013
DO - 10.1016/j.urolonc.2016.05.013
M3 - SCORING: Journal article
C2 - 27646875
VL - 34
SP - 483.e17-483.e24
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 11
ER -