Prognostic value of preoperative inflammatory markers for recurrence after transurethral resection of high-risk non-muscle-invasive bladder cancer
Objective To investigate the predictive value of preoperative inflammatory markers for tumor recurrence of high-risk non-muscle-invasive bladder cancer (NMIBC) following transurethral resection of bladder tumor (TURBT),and to develop a prediction model for tumor recurrence. Methods A retrospective analysis was conducted on data from high-risk NMIBC patients,who underwent surgical treatment at the First Affiliated Hospital of Soochow University between January 2023 and December 2023. A total of 111 patients were included in the study,comprising 94 males and 17 females,with a median age of 72 (interquartile range:68-78) years. Patients were followed-up until April 2024. According to whether there was bladder tumor recurrence,the patients were divided into recurrence and non-recurrence groups. Clinical and pathological characteristics between the two groups were compared,and independent risk factors for tumor recurrence were determined through COX multifactorial analysis. A nomogram for predicting tumor recurrence was constructed and the model fit was evaluated using calibration curve. Results The median follow-up period for all patients was 10 months (interquartile range:7-13 months). Among them,20 patients experienced recurrence (recurrence group) with an overall recurrence rate of 18.02％,while the remaining 91 patients did not experience recurrence (non-recurrence group). There were statistically significant differences between the recurrence group and the non-recurrence group in tumor stage,tumor multiplicity,neutrophil-lymphocyte ratio (NLR),platelet-lymphocyte ratio (PLR),lymphocyte-monocyte ratio (LMR),systemic immune inflammation index (SII),albumin-alkaline phosphatase ratio (AAPR),and albumin-fibrinogen ratio (AFR) (P<0.05). COX univariate and multivariate analyses revealed that tumor stage (OR=5.577,95％CI 1.214-25.618,P=0.027),NLR (OR=3.219,95％CI 1.100-9.421,P=0.033),and PLR (OR=1.017,95％CI 1.004-1.030,P=0.011) were independent risk factors for tumor recurrence after TURBT in high-risk NMIBC patients. A nomogram was created based on the results of COX multifactorial analysis to predict tumor recurrence,and the calibration curve demonstrate good model fit (x2=1.314,P=0.726). Conclusion Tumor stage,NLR and PLR are associated with tumor recurrence after TURBT in high-risk NMIBC patients,and the constructed prediction model has strong predictive capability.
inflammatory markersnon-muscle-invasive bladder cancertransurethral resection of bladder tumorpredictive model
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