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April 30, 2026Archivos Españoles de Urología1 citations

Association of Inflammatory and Nutritional Biomarkers with Pathological Response in Patients with Muscle-invasive Bladder Carcinoma Treated with Neoadjuvant Chemotherapy

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Key Points

  • This study assesses the prognostic value of inflammatory and nutritional markers in muscle-invasive bladder cancer (MIBC) patients treated with neoadjuvant chemotherapy.
  • Conducted a retrospective observational study including 133 patients with non-metastatic MIBC treated with neoadjuvant chemotherapy and radical cystectomy.
  • Analyzed preoperative inflammatory indices (NLR, TLC, PLR, LMR, SII) and nutritional index (NPI) in relation to pathological response.
  • Correlated hematologic indices with pathological outcomes and survival rates.
  • TLC, NLR, and PLR were significantly lower in patients with complete pathological response (cPR) (p <0.001, p = 0.002, p = 0.006 respectively).
  • Higher LMR values were linked to increased cPR rates (p = 0.008).
  • SII below 535,000 correlated with better survival rates (p <0.001); NPI ≥ 47 also indicated higher median survival (p = 0.002).

Abstract

Background: Bladder cancer is a prevalent urological malignancy, highlighting the need for prognostic biomarkers to optimise and individualise treatment strategies. This study aimed to assess the prognostic value of preoperative inflammatory and nutritional markers in patients with non-metastatic muscle-invasive bladder cancer (MIBC) treated with neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC), focusing on pathological response and survival. Methods: This retrospective observational study included 133 patients with non-metastatic MIBC treated with NAC and RC between July 2011 and December 2024. Preoperative inflammatory and nutritional indices, including neutrophil/lymphocyte ratio (NLR), total lymphocyte count (TLC), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), systemic immune inflammation index (SII) and nutritional prognostic index (NPI), were analysed and correlated with pathological response (complete, partial, or no response/progression). Results: Hematologic indices were associated with pathological response. Specifically, TLC (p Conclusions: Inflammatory and nutritional factors are key determinants in the response to NAC treatment in MIBC. Their use could optimise patient stratification and create new therapeutic opportunities.

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Cite This Study

A 2026 study studied this question.

synapsesocial.com/papers/69f2f1471e5f7920c6386f7dhttps://doi.org/10.56434/j.arch.esp.urol.20267903.48
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