Prognostic significance of markers of systemic inflammatory response in patients with non-muscle-invasive bladder cancer.

Détails

ID Serval
serval:BIB_5833EAC86D3D
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Prognostic significance of markers of systemic inflammatory response in patients with non-muscle-invasive bladder cancer.
Périodique
Urologic oncology
Auteur(s)
Mbeutcha A., Shariat S.F., Rieken M., Rink M., Xylinas E., Seitz C., Lucca I., Mathieu R., Rouprêt M., Briganti A., Karakiewicz P.I., Klatte T.
ISSN
1873-2496 (Electronic)
ISSN-L
1078-1439
Statut éditorial
Publié
Date de publication
11/2016
Peer-reviewed
Oui
Volume
34
Numéro
11
Pages
483.e17-483.e24
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Résumé
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.
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.
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%).
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.

Mots-clé
Adjuvants, Immunologic/therapeutic use, Aged, Antineoplastic Agents/therapeutic use, BCG Vaccine/therapeutic use, Biomarkers/blood, C-Reactive Protein/analysis, Carcinoma, Transitional Cell/blood, Carcinoma, Transitional Cell/complications, Carcinoma, Transitional Cell/pathology, Carcinoma, Transitional Cell/therapy, Combined Modality Therapy, Cystectomy, Disease Progression, Female, Humans, Leukocyte Count, Lymphocyte Count, Male, Middle Aged, Mitomycin/therapeutic use, Models, Biological, Multivariate Analysis, Neoplasm Invasiveness, Neutrophils, Prognosis, Recurrence, Retrospective Studies, Systemic Inflammatory Response Syndrome/blood, Systemic Inflammatory Response Syndrome/complications, Urinary Bladder Neoplasms/blood, Urinary Bladder Neoplasms/complications, Urinary Bladder Neoplasms/pathology, Urinary Bladder Neoplasms/therapy, BCG, Biomarker, Guideline, Prediction, Progression, Response
Pubmed
Web of science
Création de la notice
24/09/2016 11:44
Dernière modification de la notice
20/08/2019 15:12
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