Systemic inflammatory response Markers as Predictors of Oncologic Outcomes and Response to Intravesical Chemotherapy in Patients with non- muscle invasive bladder cancer

Abstract Background Patients with non-muscle invasive bladder cancer (NMIBC) maybe face the probability of recurrence or progression, yet it is difficult to seek robust prognostic indices. This study aimed to investigate the associations between the preoperative systemic inflammatory response (SIR) markers and oncologic outcomes in NMIBC . Methods We retrospectively collected data from 542 NMIBC patients undergoing transurethral resection of bladder tumor (TURBT) between January 1999 to December 2019 in peking university people's hospital. The blood samples were collected from patients before TURBT. SIR markers including systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) values were calculated. Cox proportional hazards models evaluated associations between oncologic outcomes and ratios of SIR marks. Results Recurrence and progression were observed in 31.2% and 10.3% patients respectively. Univariate and multivariate Cox regression analyses revealed that NLR (HR 1.54; 95%CI: 1.13–2.09, P = 0.007) was an independent predictive factor for RFS, and MLR (HR 2.28; 95% CI:1.30–4.02, P = 0.004) was an independent predictive factor for PFS. Patients with high NLR or MLR and no intravesical chemotherapy (IC) had the worst RFS or PFS respectively. patients with high MLR and IC had a better PFS than those without IC (P = 0.012). Conclusions Based on these results, SIR markers may be useful non-invasive and economical methods to identify patients at risk of relapse and progression and provide the probability of individual therapy for patients with NMIBC.