Prognostic value of the systemic immune-inflammation index in patients with upper tract urothelial carcinoma after radical nephroureterectomy

World Journal of Surgical Oncology

Research

Binbin Jiao¹  Zhenshan Ding²  Guan Zhang²  Yuhao Liu³  Yangxuanyu Yan³  Haijie Chen³  Yunfan Guan³  Tao Huang⁴  Zhenkai Luo⁵ 

[1] Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Gongren Tiyuchang Nanlu, 100020, Chaoyang District, Beijing, China;Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, 100029, Beijing, China;Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, 100029, Beijing, China;Peking University China-Japan Friendship School of Clinical Medicine, Yinghuadong Road, Chaoyang District, 100029, Beijing, China;Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No.300. Guangzhou Road, 210029, Nanjing, China;Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, No. 17 Nanli, Panjiayuan, Chaoyang District, 100730, Beijing, China;Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Nanli, Panjiayuan, Chaoyang District, 100021, Beijing, China;

关键词: Systemic immune-inflammation index;    Upper tract urothelial carcinoma;    Extraurothelial recurrence;    Radical nephroureterectomy;    Risk factor;   

DOI  :  10.1186/s12957-023-03225-0

 received in 2023-06-16, accepted in 2023-10-14,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo investigate the prognostic significance of the systemic immune-inflammation index (SII) for patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) and develop nomogram models for predicting overall survival (OS), intravesical recurrence (IVR), and extra-urothelial recurrence (EUR).MethodsWe retrospectively studied the clinical and pathological features of 195 patients who underwent RNU for UTUC. All patients were randomly divided into a training cohort (99 cases) and a validation cohort (96 cases). The training cohort was used to develop nomogram models, and the models were validated by the validation cohort. The least absolute shrinkage and selection operator (LASSO) regression and Cox regression were performed to identify independent predictors. The concordance index (C-index), receiver operator characteristics (ROC) analysis, and calibration plot were used to evaluate the reliability of the models. The clinical utility compared with the pathological T stage was assessed using the net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA).ResultsSII was an independent risk factor in predicting OS and EUR. The C-index values of the nomogram predicting OS, IVR, and EUR were 0.675, 0.702, and 0.756 in the training cohort and 0.715, 0.756, and 0.713 in the validation cohort. A high level of SII was correlated with the invasion of the mucosa, muscle layer of the ureter, nerves, vessels, and fat tissues.ConclusionWe developed nomogram models to predict the OS, IVR, and EUR of UTUC patients. The efficacy of these models was substantiated through internal validation, demonstrating favorable discrimination, calibration, and clinical utility. A high level of SII was associated with both worse OS and shorter EUR-free survival.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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