Immune-inflammatory-nutritional status predicts oncologic outcomes after radical cystectomy for urothelial carcinoma of bladder

Abstract

Objective: To perform the first investigation of the role of immune-inflammatory-nutritional status (INS) on oncological outcomes in patients undergoing open radical cystectomy (ORC) for urothelial carcinoma (UC).Materials and methods: The records of consecutive patients who underwent ORC for non metastatic bladder cancer between 2009 and 2020 were retrospectively analyzed. Neoadjuvant chemotherapy, non-urothelial tumor biology, and absence of oncological follow-up were exclusion criteria. Systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) values were calculated and optimal cut-off values for these were used to designate four subgroups: & DLANGBRAC;high SII-high PNI & drangbrac;, & DLANGBRAC;low SII-high PNI & drangbrac;, & DLANGBRAC;low SII-low PNI & drangbrac;, and & DLANGBRAC;high SII-low PNI & drangbrac;. The low SII-high PNI INS group had best overall survival (OS) rate while the remainder were included in non-favorable INS group. Survival curves were constructed, and a multivariate Cox regression model was used for OS and recurrence-free survival (RFS).Results: After exclusions, the final cohort size was 173 patients. The mean age was 64.31 & PLUSMN; 8.35 and median follow-up was 21 (IQR: 9-58) months. Optimal cut-off values for SII and PNI were 1216 and 47, respectively. The favorable INS group (low SII-high PNI, n = 89) had the best OS rate (62.9%). Multivariate Cox regression analysis indicated that non-favorable INS (n = 84) was a worse independent prognostic factor for OS (HR: 1.509, 95% CI: 1.104-3.145, P=.001) and RFS (HR: 1.285; 95% CI: 1.009-1.636, P=.042).Conclusion: Preoperative assessment of INS may be a useful prognostic panel for OS and RFS in patients who had ORC for UC.& COPY; 2023 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.