TY - JOUR
T1 - Systemic combining inflammatory score (SCIS)
T2 - A new score for prediction of oncologic outcomes in patients with high-risk non-muscle-invasive urothelial bladder cancer
AU - Ferro, Matteo
AU - Di Mauro, Marina
AU - Cimino, Sebastiano
AU - Morgia, Giuseppe
AU - Lucarelli, Giuseppe
AU - Abu Farhan, Abdal Rahman
AU - Vartolomei, Mihai Dorin
AU - Porreca, Angelo
AU - Cantiello, Francesco
AU - Damiano, Rocco
AU - Busetto, Gian Maria
AU - Del Giudice, Francesco
AU - Hurle, Rodolfo
AU - Perdonà, Sisto
AU - Borghesi, Marco
AU - Bove, Pierluigi
AU - Autorino, Riccardo
AU - Crisan, Nicolae
AU - Marchioni, Michele
AU - Schips, Luigi
AU - Soria, Francesco
AU - Mari, Andrea
AU - Minervini, Andrea
AU - Veccia, Alessandro
AU - Battaglia, Michele
AU - Terracciano, Daniela
AU - Musi, Gennaro
AU - Cordima, Giovanni
AU - Muto, Matteo
AU - Mirone, Vincenzo
AU - de Cobelli, Ottavio
AU - Russo, Giorgio Ivan
N1 - Publisher Copyright:
© Translational Andrology and Urology. All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background: An accurate and early diagnosis of bladder cancer (BC) is essential to offer patients the most appropriate treatment and the highest cure rate. For this reason, patients need to be best stratified by class and risk factors. We aimed to develop a score able to better predict cancer outcomes, using serum variables of inflammation. Methods: A total of 1,510 high-risk non-muscle invasive bladder cancer (NMIBC) patients were included in this retrospective observational study. Patients with pathologically proven T1 HG/G3 at first TURBT were included. Systemic combined inflammatory score (SCIS) was calculated according to systemic inflammatory markers (SIM), modified Glasgow prognostic score (mGPS), and prognostic nutritional index (PNI) dichotomized (final score from 0 to 3). Results: After 48 months of follow-up (IQR 40.0–73.0), 727 patients recurred (48.1%), 485 progressed (32.1%), 81 died for cancer (7.0%), and 163 died for overall causes (10.8%). Overall, 231 (15.3%) patients had concomitant Cis, 669 (44.3%) patients had multifocal pathology, 967 (64.1%) patients had tumor size >3 cm. Overall, 357 (23.6%) patients received immediate-intravesical therapy, 1,356 (89.8%) received adjuvant intravesical therapy, of which 1,382 (91.5%) received BCG, 266 (17.6%) patients received mitomycin C, 4 (0.5%) patients received others intravesical therapy. Higher SCIS was independently predictive of recurrence (hazard ratio HR 1.5, 1.3 and 2.2) and cancer specific mortality for SCIS 0 and 3 (HR: 1.61 and 2.3), and overall mortality for SCIS 0 and 3 (HR: 2.4 and 3.2). Conversely, SCIS was not associated with a higher probability of progression. Conclusions: The inclusion of the SCIS in clinical practice is simple to apply and can help improve the prediction of cancer outcomes. It can identify patients with high-grade BC who are more likely to experience disease mortality.
AB - Background: An accurate and early diagnosis of bladder cancer (BC) is essential to offer patients the most appropriate treatment and the highest cure rate. For this reason, patients need to be best stratified by class and risk factors. We aimed to develop a score able to better predict cancer outcomes, using serum variables of inflammation. Methods: A total of 1,510 high-risk non-muscle invasive bladder cancer (NMIBC) patients were included in this retrospective observational study. Patients with pathologically proven T1 HG/G3 at first TURBT were included. Systemic combined inflammatory score (SCIS) was calculated according to systemic inflammatory markers (SIM), modified Glasgow prognostic score (mGPS), and prognostic nutritional index (PNI) dichotomized (final score from 0 to 3). Results: After 48 months of follow-up (IQR 40.0–73.0), 727 patients recurred (48.1%), 485 progressed (32.1%), 81 died for cancer (7.0%), and 163 died for overall causes (10.8%). Overall, 231 (15.3%) patients had concomitant Cis, 669 (44.3%) patients had multifocal pathology, 967 (64.1%) patients had tumor size >3 cm. Overall, 357 (23.6%) patients received immediate-intravesical therapy, 1,356 (89.8%) received adjuvant intravesical therapy, of which 1,382 (91.5%) received BCG, 266 (17.6%) patients received mitomycin C, 4 (0.5%) patients received others intravesical therapy. Higher SCIS was independently predictive of recurrence (hazard ratio HR 1.5, 1.3 and 2.2) and cancer specific mortality for SCIS 0 and 3 (HR: 1.61 and 2.3), and overall mortality for SCIS 0 and 3 (HR: 2.4 and 3.2). Conversely, SCIS was not associated with a higher probability of progression. Conclusions: The inclusion of the SCIS in clinical practice is simple to apply and can help improve the prediction of cancer outcomes. It can identify patients with high-grade BC who are more likely to experience disease mortality.
KW - Bladder cancer (BC)
KW - Immune system
KW - Inflammation
KW - Outcomes
KW - Prognosis
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UR - http://www.scopus.com/inward/citedby.url?scp=85102719593&partnerID=8YFLogxK
U2 - 10.21037/TAU-20-1272
DO - 10.21037/TAU-20-1272
M3 - Article
AN - SCOPUS:85102719593
VL - 10
SP - 626
EP - 635
JO - Translational Andrology and Urology
JF - Translational Andrology and Urology
SN - 2223-4683
IS - 2
ER -