Value of Preoperative Inflammatory Burden Index in Predicting Overall Survival and Progression in Nonmetastatic...

This study evaluates the prognostic significance of the inflammatory burden index (IBI) and related systemic inflammatory markers, namely, C-reactive protein-to-albumin ratio (CAR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and pan-immune inflammation value (PIV), in predicting survival outcomes in patients with nonmetastatic muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC).

A total of 115 patients treated between January 2014 and January 2023 were included. IBI, CAR, SII, PLR, MLR, SIRI, NLR, and PIV were calculated. Kaplan-Meier, Cox regression, and receiver operating characteristic (ROC) curve analyses were performed to determine the impact of these biomarkers on overall survival (OS) and progression-free survival (PFS).

ROC analysis for OS prediction revealed the highest predictive accuracy for PIV (area under curve (AUC) = 0.784, p < 0.001), followed by SIRI (AUC = 0.751) and IBI (AUC = 0.747). For PFS prediction, IBI demonstrated the strongest predictive value (AUC = 0.672, p = 0.002), followed by CAR (AUC = 0.663, p = 0.003) and PIV (AUC = 0.662, p = 0.003). Multivariate Cox regression analysis identified PIV (hazard ratio (HR) = 3.673, p < 0.001), SIRI (HR = 3.074, p < 0.001), and IBI (HR = 2.209, p = 0.002) as independent predictors of OS. High IBIs were significantly associated with advanced tumor stage (T stage) (p = 0.025), lymphovascular invasion (p = 0.002), and perineural invasion (p = 0.023) but not with lymph node metastasis (p = 0.713).

IBI and associated hematological markers are valuable for predicting survival outcomes in patients with MIBC. The findings support the integration of these biomarkers with other prognostic tools to enhance the accuracy of treatment outcome predictions.