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Absolute basophil count is associated with time to recurrence in patients with high-grade T1 bladder cancer receiving bacillus Calmette–Guérin after transurethral resection of the bladder tumor

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Abstract

Background

Basophils, eosinophils and monocytes may be involved in BCG-induced immune responses and be associated with outcomes of bladder cancer patients receiving intravesical BCG. Our objective was to explore the association of baseline counts of basophils, eosinophils and monocytes with outcomes of patients with high-grade T1 bladder cancer receiving a standard course of intravesical BCG.

Methods

We retrospectively reviewed medical records of patients with primary T1 HG/G3 bladder cancer. After re-TURBT, patients were treated with a 6-week course of intravesical BCG induction followed by intravesical BCG every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months from initiation of therapy The analysis of potential risk factors for recurrence, muscle invasion and cancer-specific and overall survival was performed using univariable Cox regression models. Those factors that presented, at univariate analysis, an association with the event at a liberal p < 0.1, have been selected for the development of a multivariable model.

Results

A total of 1045 patients with primary T1 HG/G3 were included. A total of 678 (64.9%) recurrences, 303 (29.0%) progressions and 150 (14.3%) deaths were observed during follow-up. Multivariate analysis showed that logarithmic transformation of basophils count was associated with a 30% increment in the hazard of recurrence per unit increase of logarithmic basophils count (HR 1.30; 95% confidence interval 1.09–1.54; p = 0.0026). Basophil count modeled by quartiles was also significantly associated with time to recurrence [second vs. lower quartile HR 1.42 (1.12–1.79); p = 0.003, third vs. lower quartile HR 1.26 (1.01–1.57); p = 0.041; upper vs. lower quartile HR 1.36 (1.1–1.68); p = 0.005]. The limitations of a retrospective study are applicable.

Conclusion

Baseline basophil count may predict recurrence in BCG-treated HG/G3 T1 bladder cancer patients. External validation is warranted.

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Authors and Affiliations

  1. Division of Urology, European Institute of Oncology, via Ripamonti 435, Milan, Italy

    M. Ferro, M. D. Vartolomei, G. Musi & O. De Cobelli

  2. Department of Urology, Medical University of Vienna, Vienna, Austria

    S. Shariat

  3. Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania

    M. D. Vartolomei

  4. Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy

    F. Cantiello, R. Damiano & A. R. Abu Farhan

  5. Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy

    G. Lucarelli & M. Battaglia

  6. Department of Experimental Medicine and Surgery, Tor Vegata University, Rome, Italy

    S. Di Stasi

  7. Department of Urology, Istituto Clinico Humanitas Istituto di Ricovero e Cura a Carattere Scientifico-Clinical and Research Hospital, Milan, Italy

    R. Hurle

  8. Department of Biomedical Science, Humanitas University, Milan, Rozzano, Italy

    G. Guazzoni

  9. Department of Urology, Sapienza University of Rome, Rome, Italy

    G. M. Busetto, A. Gabriele & F. Del Giudice

  10. Uro-Gynecological Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione “G. Pascale” IRCCS, Naples, Italy

    F. Perri & S. Perdona

  11. Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples “Federico II”, Naples, Italy

    P. Verze & V. Mirone

  12. Department of Urology, University of Bologna, Bologna, Italy

    M. Borghesi & R. Schiavina

  13. Departamento de Urologia, University of Vale do Itajaí, Itajaí, Brazil

    G. L. Almeida

  14. Division of Urology, Department of Experimental Medicine and Surgery, Urology Unit, Tor Vergata University of Rome, Rome, Italy

    P. Bove

  15. Life and Health Sciences Research Institute, University of Minho, Braga, Portugal

    E. Lima

  16. Division of Urology, Virginia Commonwealth University, Richmond, VA, USA

    R. Autorino

  17. Department of Urology, University of Medicine and Pharmacy “Iuliu Haţeganu,”, Cluj-Napoca, Romania

    N. Crisan

  18. Department of Urology, University of Catania, Catania, Italy

    G. I. Russo & G. Morgia

  19. Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy

    D. Terracciano

  20. Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy

    G. Di Lorenzo, Vincenzo Ieluzzi, P. De Placido, L. Scafuri & C. Buonerba

  21. Department of Public Health, Federico II University of Naples, Naples, Italy

    D. Bruzzese

  22. Zoo-prophylactic Institute of Southern Italy, Portici, Italy

    C. Buonerba

  23. Dana-Farber Cancer Institute, GU Oncology Division, Harvard Medical School, Boston, MA, USA

    Guru Sonpavde

  24. Institute of Genetics and Biophysics “A. Buzzati-Traverso”, CNR, Naples, Italy

    A. Cimmino

  25. Department of Medicine, Università degli Studi del Molise, Campobasso, Italy

    G. Di Lorenzo

Authors
  1. M. Ferro
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  2. G. Di Lorenzo
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  3. M. D. Vartolomei
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  4. D. Bruzzese
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  5. F. Cantiello
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  6. G. Lucarelli
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  7. G. Musi
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  8. S. Di Stasi
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  14. R. Damiano
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  15. F. Perri
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  18. M. Borghesi
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  20. G. L. Almeida
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  21. P. Bove
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  22. E. Lima
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  23. R. Autorino
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  25. A. R. Abu Farhan
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  26. M. Battaglia
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  27. G. I. Russo
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  28. Vincenzo Ieluzzi
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  29. G. Morgia
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  30. P. De Placido
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  31. D. Terracciano
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  32. A. Cimmino
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  33. L. Scafuri
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  34. V. Mirone
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  35. O. De Cobelli
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  36. S. Shariat
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  38. C. Buonerba
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Contributions

MF: project development; data management; data analysis. GDL: project development; data management; data analysis. MDV: project development; manuscript editing. DB: data analysis. FC: Data collection. GL: Project development; manuscript editing. GM: project development; manuscript editing. SDS: project development; manuscript editing. RH: project development; manuscript editing. GG: project development; manuscript editing. GMB: project development; manuscript editing. AG: data management and collection. FDG: data management and collection. RD: data management and collection. FP: project development; manuscript editing. SP: project development; manuscript editing. PV: data management and collection. MB: data management and collection. RS: project development; manuscript editing. GLA: data management and collection. PB: data management and collection. EL: data management and collection. RA: project development; manuscript editing. NC: data management and collection. ARAF: data management and collection. MB: project development; manuscript editing. GIR: data management and collection. VI: project development; manuscript editing. GM: project development; manuscript editing. PDP: project development; manuscript editing. DT: project development; manuscript editing. AC: project development; manuscript editing. LS: project development; manuscript editing. VM: project development; manuscript editing. OdC: project development; manuscript editing. SS: project development; manuscript editing. GS: project development; manuscript editing. CB: conception of the original research hypothesis; project development; data management; data analysis: manuscript writing.

Corresponding author

Correspondence to M. Ferro.

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This was a retrospective study involving Human Participants treated according to standard clinical practice. All permissions granted by competent Ethics Committees and other authorities were obtained and all informed consents required by the existing law and regulations were collected.

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Ferro, M., Di Lorenzo, G., Vartolomei, M.D. et al. Absolute basophil count is associated with time to recurrence in patients with high-grade T1 bladder cancer receiving bacillus Calmette–Guérin after transurethral resection of the bladder tumor. World J Urol 38, 143–150 (2020). https://doi.org/10.1007/s00345-019-02754-2

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