Prognostic Values of Inflammatory Markers in Patients with High-grade Lamina Propria-invasive Bladder Cancer

EAU) CIOMC 2014 recommendation.For patients in the very high-risk group, the guidelines suggest an early cystectomy (7).In BCG-refractory tumors, early cystectomy is also advised.Delayed early cystectomy is associated with lower cancer-specific survival (8).However, the presence of lymphovascular invasion (LVI) and the presence of some variant histology (VH), which are suggested for early cystectomy in the EAU NMIBC guidelines, were not validated in the nomograms.Among the inflammatory parameters in the literature, neutrophil lymphocyte ratio (NLR) (9), platelet lymphocyte ratio (PLR) (10) and systemic inflammatory markers (SIM) score (11) were associated with recurrence, and NLR (9), lymphocyte monocyte ratio (LMR) ( 12) and SIM score (11) were associated with progression.Therefore, in this study, the prognostic value of pathological parameters such as depth of lamina propria invasion, VH, and AbstractObjective: In this study, we investigated the prognostic values of various pathological and inflammatory parameters in patients with high-grade lamina propriainvasive (T1G3) bladder cancer (BC).Materials and Methods: Between 2006 and 2018, patients with pathological evaluation of T1G3 bladder urothelial carcinoma in our institution who did not meet the exclusion criteria were included in the study.Parameters such as gender, tumor diameter, tumor number, lamina propria invasion depth, presence of carcinoma in situ, presence of lymphovascular invasion (LVI), presence of variant histology, lymphocyte monocyte ratio (LMR), platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR), and systemic inflammatory markers (SIM) were statistically analyzed.Results: After the exclusion criteria were evaluated, 76 patients were included in the study from 157 patients.Recurrence was observed in 37 (48.68%)patients, and progression was observed in 21 (27.63%)patients.A significant relationship was discovered between LMR (p<0,001), PLR (p<0.004),NLR (p<0.002),tumor diameter (p<0.002),number of tumors (p<0,007), and SIM score (p<0,001) with the probability of recurrence.The probability of progression was associated with NLR (p<0.023),LVI (p<0.005),tumor diameter (p<0.012) and tumor number (p<0.001).A significant relationship was found between SIM (p<0.041) and recurrencefree survival.We found a significant relationship between LVI (p<0.022) and progression-free survival.Conclusions: In this study, we found positive correlations between some inflammatory markers and recurrence/progression in patients with T1G3 BC.According to our study, inflammatory parameters such as NLR, PLR, LMR, and SIM score should be evaluated while investigating the possibility of recurrence/progression in patients with T1G3 BC.