Predictive value of systemic inflammatory response markers before treatment of non-muscle invasive bladder cancer patients, initial intravesical Bacillus Calmette-Guerin treatment after transurethral resection of bladder tumor

The study investigated the pretreatment systemic inflammatory response (SIR) markers of patients who underwent initial intravesical treatment for high-risk non-muscle invasive bladder cancer (NMIBC). 385 patients who underwent initial intravesical Bacillus Calmette-Guerin treatment after transurethral resection of bladder tumor were included. We analyzed the relationship between standardized incidence ratio of SIR markers, such as neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR) and platelet-to-lymphocyte ratio (PLR), and oncological outcomes. Each SIR marker was used for analysis by determining the cut-off value through receiver operation characteristics curves analysis. Patients were divided into two groups according to pretreatment NLR (&lt;1.5 vs ≥1.5), dNLR (&lt;1.2 vs ≥1.2) and PLR values (171 Cox multivariate analysis revealed that age. NLR, dNLR, hemoglobin, and pathologic T stage were important factors for predicting overall survival. Age, NLR, and pathologic T stage were important factors for predicting cancer-specific survival, NLR and tumor number were the most important predictors of bladder preserving survival.<b> </b>NLR before treatment was correlated with both oncological outcomes and survival outcome in NMIBC patients undergoing initial intravesical BCG treatment after TURB. Increased NLR reflects a poor prognosis of these outcomes.