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Can The Systemic Immune Inflammation Index Be A Predictor Of BCG Response In Patients With High-Risk Non-Muscle Invasive Bladder Cancer?
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  • Serkan Akan,
  • Caner Ediz,
  • Aytaç Şahin,
  • Hasan Huseyin Tavukcu,
  • Ahmet Ürkmez,
  • Alper Horasan,
  • Omer Yilmaz,
  • Ayhan Verit
Serkan Akan
Sultan Abdülhamid Han Training and Research Hospital
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Caner Ediz
Sultan Abdulhamid Han Egitim ve Arastirma Hastanesi
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Aytaç Şahin
Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital
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Hasan Huseyin Tavukcu
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Ahmet Ürkmez
The University of Texas MD Anderson Cancer Center
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Alper Horasan
Sultan Abdulhamid Han Egitim ve Arastirma Hastanesi
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Omer Yilmaz
Sultan Abdulhamid Han Egitim ve Arastirma Hastanesi
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Ayhan Verit
Health Sciences University, Fatih Sultan Mehmet Training and Research Hospital
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Abstract

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, neutrophile lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence free survival (RFS) and progression free survival (PFS). The prognostic ability of the SII for progression was analyzed 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. A 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=0.003) and a higher SII increased the progression one-fold. A tumor 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 randomized controlled studies with large patient groups.

Peer review status:Published

04 Oct 2020Submitted to International Journal of Clinical Practice
06 Oct 2020Submission Checks Completed
06 Oct 2020Assigned to Editor
08 Oct 2020Reviewer(s) Assigned
11 Oct 2020Review(s) Completed, Editorial Evaluation Pending
18 Oct 20201st Revision Received
19 Oct 2020Submission Checks Completed
19 Oct 2020Assigned to Editor
19 Oct 2020Reviewer(s) Assigned
20 Oct 2020Review(s) Completed, Editorial Evaluation Pending
02 Nov 2020Editorial Decision: Accept
20 Nov 2020Published in International Journal of Clinical Practice. 10.1111/ijcp.13813