Open AccessCan the systemic immune inflammation index be a predictor of BCG response in patients with high‐risk non‐muscle invasive bladder cancer?
Author(s) -
Akan Serkan,
Ediz Caner,
Sahin Aytac,
Tavukcu Hasan Huseyin,
Urkmez Ahmet,
Horasan Alper,
Yilmaz Omer,
Verit Ayhan
Publication year - 2021
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.13813
Subject(s) - medicine , bladder cancer , pathological , lymphocyte , oncology , neutrophil to lymphocyte ratio , multivariate analysis , immune system , peripheral , area under the curve , gastroenterology , cancer , immunology
Aim We 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). Methods A 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. Results The 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. Conclusions The 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.