Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer
We investigated the prognosis of BCG induction-only treatment and non-complete response (CR) at the first 3-month evaluation and examined factors associated with CR. In total, 209 patients with moderate- and high-risk NMIBC who received BCG induction-only treatment between 2008 and 2020 were retrosp...
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MDPI AG
2023-10-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/19/3114 |
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| author | Junghoon Lee Sangjun Yoo Min Soo Choo Min Chul Cho Hwancheol Son Hyeon Jeong |
| author_facet | Junghoon Lee Sangjun Yoo Min Soo Choo Min Chul Cho Hwancheol Son Hyeon Jeong |
| author_sort | Junghoon Lee |
| collection | DOAJ |
| description | We investigated the prognosis of BCG induction-only treatment and non-complete response (CR) at the first 3-month evaluation and examined factors associated with CR. In total, 209 patients with moderate- and high-risk NMIBC who received BCG induction-only treatment between 2008 and 2020 were retrospectively analyzed. Recurrence-free survival (RFS) and progression-free survival (PFS) were assessed based on the initial NMIBC stage. PFS and associated factors of non-CR compared to CR were also assessed. Initial T1 high-grade (HG) (<i>n</i> = 93) had poorer RFS and PFS after BCG induction-only treatment than Ta low-grade (LG) (<i>p</i> = 0.029, <i>p</i> = 0.002). Non-CR (<i>n</i> = 37) had a different neutrophil-to-lymphocyte ratio (NLR) (2.81 ± 1.02 vs. 1.97 ± 0.92) and T staging from CR (<i>p</i> < 0.001, <i>p</i> = 0.008). T1HG recurrence was associated with a worse PFS compared to non-T1HG (13.7 months vs. 101.7 months, <i>p</i> < 0.001). There was no difference in PFS between T1HG and T1LG. T1 and NLR were predictors of response at 3 months in multivariable analysis (<i>p</i> = 0.004, <i>p</i> = 0.029). NLR was also found to be an associated factor with RFS and PFS of bladder cancer (<i>p</i> < 0.001, <i>p</i> < 0.001). BCG induction-only treatment was effective for high-risk TaLG but not for T1HG. T1HG recurrence at 3 months after BCG induction has a poor prognosis for bladder cancer. Preoperative NLR and T1 were predictors of non-CR, and NLR was also associated with the long-term prognosis of bladder cancer. |
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| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T21:47:03Z |
| publishDate | 2023-10-01 |
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| series | Diagnostics |
| spelling | doaj.art-ca15a712105c48288f1b02fd301976f92023-11-19T14:14:58ZengMDPI AGDiagnostics2075-44182023-10-011319311410.3390/diagnostics13193114Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder CancerJunghoon Lee0Sangjun Yoo1Min Soo Choo2Min Chul Cho3Hwancheol Son4Hyeon Jeong5Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDepartment of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDepartment of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDepartment of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDepartment of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaDepartment of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of KoreaWe investigated the prognosis of BCG induction-only treatment and non-complete response (CR) at the first 3-month evaluation and examined factors associated with CR. In total, 209 patients with moderate- and high-risk NMIBC who received BCG induction-only treatment between 2008 and 2020 were retrospectively analyzed. Recurrence-free survival (RFS) and progression-free survival (PFS) were assessed based on the initial NMIBC stage. PFS and associated factors of non-CR compared to CR were also assessed. Initial T1 high-grade (HG) (<i>n</i> = 93) had poorer RFS and PFS after BCG induction-only treatment than Ta low-grade (LG) (<i>p</i> = 0.029, <i>p</i> = 0.002). Non-CR (<i>n</i> = 37) had a different neutrophil-to-lymphocyte ratio (NLR) (2.81 ± 1.02 vs. 1.97 ± 0.92) and T staging from CR (<i>p</i> < 0.001, <i>p</i> = 0.008). T1HG recurrence was associated with a worse PFS compared to non-T1HG (13.7 months vs. 101.7 months, <i>p</i> < 0.001). There was no difference in PFS between T1HG and T1LG. T1 and NLR were predictors of response at 3 months in multivariable analysis (<i>p</i> = 0.004, <i>p</i> = 0.029). NLR was also found to be an associated factor with RFS and PFS of bladder cancer (<i>p</i> < 0.001, <i>p</i> < 0.001). BCG induction-only treatment was effective for high-risk TaLG but not for T1HG. T1HG recurrence at 3 months after BCG induction has a poor prognosis for bladder cancer. Preoperative NLR and T1 were predictors of non-CR, and NLR was also associated with the long-term prognosis of bladder cancer.https://www.mdpi.com/2075-4418/13/19/3114non-muscle-invasive bladder neoplasmsBCG inductionnon-complete responseBCG failureneutrophil-to-lymphocytes ratio |
| spellingShingle | Junghoon Lee Sangjun Yoo Min Soo Choo Min Chul Cho Hwancheol Son Hyeon Jeong Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer Diagnostics non-muscle-invasive bladder neoplasms BCG induction non-complete response BCG failure neutrophil-to-lymphocytes ratio |
| title | Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer |
| title_full | Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer |
| title_fullStr | Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer |
| title_full_unstemmed | Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer |
| title_short | Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette–Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer |
| title_sort | prognostic role of preoperative neutrophil to lymphocyte ratio nlr and recurrence at first evaluation after bacillus calmette guerin bcg induction in non muscle invasive bladder cancer |
| topic | non-muscle-invasive bladder neoplasms BCG induction non-complete response BCG failure neutrophil-to-lymphocytes ratio |
| url | https://www.mdpi.com/2075-4418/13/19/3114 |
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