Systemic Inflammatory Index: A Promising Non-Invasive Marker for the Prediction of Response to Neoadjuvant Chemotherapy prior to Cystectomy.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2024-01-01 Epub Date: 2024-02-17 DOI:10.1159/000537894

Levent Ozcan, Emre Can Polat, Caner Baran, Ahmet Boylu, Mustafa Erkoc, Alper Otunctemur

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引用次数: 0

Abstract

Introduction: The main challenge to the optimal use of neoadjuvant chemotherapy (NAC) is the difficulty in selecting patients who may or may not benefit from NAC. Our aim in this study was to investigate whether the Systemic Inflammatory Index (SII) predicts response to chemotherapy in patients who receive NAC prior to cystectomy.

Methods: We retrospectively analysed the data of patients who underwent NAC followed by cystectomy at our institution between January 2010 and September 2015 and whose 5-year follow-up was completed. All patients who underwent diagnostic biopsy with complete transurethral resection of bladder tumour at our hospital and whose pathology result was muscle-invasive transitional cell carcinoma were included in the study. At least 3 courses of gemcitabine/cisplatin NAC were given to all patients. A pathological response was defined as a reduction in cystectomy to a lower pathological stage after NAC.

Results: The SII was 320.8 ± 51 in the responders and 388.28 ± 50 in the non-responders. SII optimal cut-off of 350 was determined. The sensitivity and specificity of SII in predicting response were found to be 80% and 83%, respectively. Low SII (<350) was found to be a significant predictor of response compared with the other factors on multivariate analysis. The mean overall survival time was 55.4 months in patients with a low SII value and 40.3 months in the high SII group.

Conclusion: SII, together with known clinicopathological factors and newer genetic and molecular markers, can be used to select patients for NAC.

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全身炎症指数：预测膀胱切除术前新辅助化疗反应的前景看好的非侵入性标志物。

导言：优化使用新辅助化疗（NAC）面临的主要挑战是难以选择可能受益于或可能无法受益于NAC的患者。本研究旨在探讨全身炎症指数（SII）是否能预测在膀胱切除术前接受新辅助化疗的患者对化疗的反应：我们回顾性分析了 2010 年 1 月至 2015 年 9 月期间在我院接受 NAC 后进行膀胱切除术并完成 5 年随访的患者数据。所有在我院接受诊断性活组织检查和完全经尿道膀胱肿瘤切除术，且病理结果为肌层浸润性过渡细胞癌的患者均纳入研究。所有患者均接受了至少 3 个疗程的吉西他滨/顺铂新农合治疗。病理反应的定义是，NAC后膀胱切除术的病理分期降低：结果：有反应者的 SII 为 320.8 ± 51，无反应者为 388.28 ± 50。SII 最佳临界值为 350。结果发现，SII 预测反应的敏感性和特异性分别为 80% 和 83%。多变量分析发现，与其他因素相比，低 SII（< 350）是预测反应的一个重要因素。SII值低的患者平均总生存时间为55.4个月，SII值高的患者平均总生存时间为40.3个月：结论：SII与已知的临床病理因素以及较新的基因和分子标记物一起，可用于选择接受新农合治疗的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.