The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial Carcinoma

Purpose This study aims to evaluate the systemic inflammatory response indices (SII) for the prediction of the non–organ-confined (non-OC) disease in upper urinary tract urothelial carcinoma (UTUC) patients. Materials and Methods From March 2010 to March 2020, patients who underwent radical nephrour...

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Main Authors: Sung Kyung Choi, Chan Hoon Gwak, Jungyo Suh, Bumjin Lim, Cheryn Song, Dalsan You, In Gab Jeong, Jun Hyuk Hong, Bumsik Hong, Choung-Soo Kim, Hanjong Ahn
Format: Article
Language:English
Published: Korean Urological Oncology Society 2023-07-01
Series:Journal of Urologic Oncology
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Online Access:http://www.e-juo.org/upload/pdf/juo-21-2-174.pdf
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author Sung Kyung Choi
Chan Hoon Gwak
Jungyo Suh
Bumjin Lim
Cheryn Song
Dalsan You
In Gab Jeong
Jun Hyuk Hong
Bumsik Hong
Choung-Soo Kim
Hanjong Ahn
author_facet Sung Kyung Choi
Chan Hoon Gwak
Jungyo Suh
Bumjin Lim
Cheryn Song
Dalsan You
In Gab Jeong
Jun Hyuk Hong
Bumsik Hong
Choung-Soo Kim
Hanjong Ahn
author_sort Sung Kyung Choi
collection DOAJ
description Purpose This study aims to evaluate the systemic inflammatory response indices (SII) for the prediction of the non–organ-confined (non-OC) disease in upper urinary tract urothelial carcinoma (UTUC) patients. Materials and Methods From March 2010 to March 2020, patients who underwent radical nephroureterectomy (RNU) in a single tertiary center were retrospectively reviewed. Tumor location, multifocality, hydronephrosis on preoperative imaging, and preoperative SII, including C-reactive protein-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR) were used for analysis. Non-OC defined by locally advanced (pT3-4) or node-positive disease (pN1-2) in pathologic examination. Multivariable logistic regression was used for determining independent predictive markers of non-OC disease. Factors associated with locally advanced (pT3-4), and node-positive (pN1-2) disease were also analyzed. Results Overall, 711 UTUC patients who underwent RNU, without neoadjuvant chemotherapy, were analyzed. The average age was 68.6±9.9 years and 507 patients were male. Non-OC disease was 36.8% (262 of 711); specifically, 35.9% (255 of 711) was locally advanced and 7.2% (51 of 771) was node-positive disease. Multivariable analysis demonstrated hydronephrosis (odds ratio [OR], 1.46; 95%confidence interval [CI], 1.06–2.01; p=0.02), high PLR (OR, 1.45; 95% CI, 1.05–2.01; p=0.03), and high CAR (OR, 2.56; 95% CI, 1.79–3.66; p<0.01) were independent predictive markers non-OC disease. Hydronephrosis (p=0.01), high PLR (p=0.02), and high CAR (p<0.01) were predictive markers for locally advanced disease, and multifocal tumor (p<0.01) and high CAR (p<0.01) were predictive markers for node-positive disease. Conclusions CAR is a novel important factor for predicting any subtype of non-OC disease among SII. Large scale, multicenter studies should validate the clinical role of CAR.
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spelling doaj-art-076cffb068d641538e3009e25c351ba12025-08-20T02:38:45ZengKorean Urological Oncology SocietyJournal of Urologic Oncology2951-603X2982-70432023-07-0121217418010.22465/juo.224400580029547The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial CarcinomaSung Kyung Choi0Chan Hoon Gwak1Jungyo Suh2Bumjin Lim3Cheryn Song4Dalsan You5In Gab Jeong6Jun Hyuk Hong7Bumsik Hong8Choung-Soo Kim9Hanjong Ahn10 Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, Korea Department of Urology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea Department of Urology, Asian Medical Center, Ulsan University College of Medicine, Seoul, KoreaPurpose This study aims to evaluate the systemic inflammatory response indices (SII) for the prediction of the non–organ-confined (non-OC) disease in upper urinary tract urothelial carcinoma (UTUC) patients. Materials and Methods From March 2010 to March 2020, patients who underwent radical nephroureterectomy (RNU) in a single tertiary center were retrospectively reviewed. Tumor location, multifocality, hydronephrosis on preoperative imaging, and preoperative SII, including C-reactive protein-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR) were used for analysis. Non-OC defined by locally advanced (pT3-4) or node-positive disease (pN1-2) in pathologic examination. Multivariable logistic regression was used for determining independent predictive markers of non-OC disease. Factors associated with locally advanced (pT3-4), and node-positive (pN1-2) disease were also analyzed. Results Overall, 711 UTUC patients who underwent RNU, without neoadjuvant chemotherapy, were analyzed. The average age was 68.6±9.9 years and 507 patients were male. Non-OC disease was 36.8% (262 of 711); specifically, 35.9% (255 of 711) was locally advanced and 7.2% (51 of 771) was node-positive disease. Multivariable analysis demonstrated hydronephrosis (odds ratio [OR], 1.46; 95%confidence interval [CI], 1.06–2.01; p=0.02), high PLR (OR, 1.45; 95% CI, 1.05–2.01; p=0.03), and high CAR (OR, 2.56; 95% CI, 1.79–3.66; p<0.01) were independent predictive markers non-OC disease. Hydronephrosis (p=0.01), high PLR (p=0.02), and high CAR (p<0.01) were predictive markers for locally advanced disease, and multifocal tumor (p<0.01) and high CAR (p<0.01) were predictive markers for node-positive disease. Conclusions CAR is a novel important factor for predicting any subtype of non-OC disease among SII. Large scale, multicenter studies should validate the clinical role of CAR.http://www.e-juo.org/upload/pdf/juo-21-2-174.pdftransitional cell carcinomac-reactive proteinalbuminsnephroureterectomy
spellingShingle Sung Kyung Choi
Chan Hoon Gwak
Jungyo Suh
Bumjin Lim
Cheryn Song
Dalsan You
In Gab Jeong
Jun Hyuk Hong
Bumsik Hong
Choung-Soo Kim
Hanjong Ahn
The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial Carcinoma
Journal of Urologic Oncology
transitional cell carcinoma
c-reactive protein
albumins
nephroureterectomy
title The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial Carcinoma
title_full The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial Carcinoma
title_fullStr The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial Carcinoma
title_full_unstemmed The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial Carcinoma
title_short The Predictive Value of the Preoperative Systemic Inflammatory Response Indices in Non–Organ-Confined Disease in Upper Urinary Tract Urothelial Carcinoma
title_sort predictive value of the preoperative systemic inflammatory response indices in non organ confined disease in upper urinary tract urothelial carcinoma
topic transitional cell carcinoma
c-reactive protein
albumins
nephroureterectomy
url http://www.e-juo.org/upload/pdf/juo-21-2-174.pdf
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