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The prognostic value of the preoperative lung immune prognostic index in patients with urothelial bladder cancer undergoing radical cystectomy

International Journal of Clinical Oncology volume 27, pages 396–402 (2022)Cite this article

Abstract

Background

The lung immune prognostic index (LIPI) predicts the prognosis of patients with advanced non-small-cell lung cancer and is a prognostic biomarker for renal cell carcinoma and melanoma; however, no study has evaluated its potential as a preoperative biomarker for patients with bladder cancer (BC). We investigated the LIPI as a preoperative prognostic biomarker in patients undergoing radical cystectomy.

Methods

We retrospectively analyzed the clinical records of 105 patients with BC who underwent radical cystectomy from January 2013 to June 2019. The LIPI was evaluated based on the preoperatively derived neutrophil–lymphocyte ratio and the lactate dehydrogenase levels. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan–Meier curves and decision curve analysis (DCA) were performed to assess the disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS) rates.

Results

The patients were classified into the good, intermediate, and poor LIPI groups [71 (67.6%), 28 (26.7%), and 6 (5.7%) patients, respectively]. IPTW-adjusted Kaplan–Meier curve analyses showed that patients with intermediate to poor LIPI had worse DFS, CSS, and OS rates than those with good LIPI. The LIPI combined with pT3/4 and lymph node metastasis could better assess the prognosis of DFS at 24 months postoperatively by DCA.

Conclusion

The preoperative LIPI can predict the prognosis of patients with BC undergoing radical cystectomy and has a better predictive ability when combined with pT3/4 and lymph node metastasis.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Urology, The Jikei University School of Medicine, 3-19-18, Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan

    Koki Obayashi, Jun Miki, Wataru Fukuokaya, Takafumi Yanagisawa, Shoji Kimura, Shunsuke Tsuzuki, Takahiro Kimura & Shin Egawa

Authors
  1. Koki Obayashi
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  2. Jun Miki
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  3. Wataru Fukuokaya
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  4. Takafumi Yanagisawa
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  5. Shoji Kimura
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  6. Shunsuke Tsuzuki
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  7. Takahiro Kimura
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  8. Shin Egawa
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by WF and KO. The first draft of the manuscript was written by KO, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Koki Obayashi.

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Obayashi, K., Miki, J., Fukuokaya, W. et al. The prognostic value of the preoperative lung immune prognostic index in patients with urothelial bladder cancer undergoing radical cystectomy. Int J Clin Oncol 27, 396–402 (2022). https://doi.org/10.1007/s10147-021-02059-8

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  • DOI: https://doi.org/10.1007/s10147-021-02059-8

Keywords

  • Lung immune prognostic index
  • Bladder cancer
  • Radical cystectomy
  • dNLR
  • Inverse probability of treatment weighting