Modified Glasgow Prognostic Score as a Predictor of Recurrence in Patients with High Grade Non-Muscle Invasive Bladder Cancer Undergoing Intravesical Bacillus Calmette–Guerin Immunotherapy
Matteo Ferro,
Octavian Sabin Tătaru,
Gennaro Musi,
Giuseppe Lucarelli,
Abdal Rahman Abu Farhan,
Francesco Cantiello,
Rocco Damiano,
Rodolfo Hurle,
Roberto Contieri,
Gian Maria Busetto,
Giuseppe Carrieri,
Luigi Cormio,
Francesco Del Giudice,
Alessandro Sciarra,
Sisto Perdonà,
Marco Borghesi,
Carlo Terrone,
Evelina La Civita,
Pierluigi Bove,
Riccardo Autorino,
Matteo Muto,
Nicolae Crisan,
Michele Marchioni,
Luigi Schips,
Francesco Soria,
Daniela Terracciano,
Rocco Papalia,
Felice Crocetto,
Biagio Barone,
Giorgio Ivan Russo,
Stefano Luzzago,
Giuseppe Mario Ludovico,
Mihai Dorin Vartolomei,
Francesco Alessandro Mistretta,
Vincenzo Mirone,
Ottavio de Cobelli
Affiliations
Matteo Ferro
Division of Urology, European Institute of Oncology, Milan IRCCS, 20141 Milan, Italy
Octavian Sabin Tătaru
I.O.S.U.D., George Emil Palade University of Medicine and Pharmacy, Science and Technology, 540142 Targu Mures, Romania
Gennaro Musi
Division of Urology, European Institute of Oncology, Milan IRCCS, 20141 Milan, Italy
Giuseppe Lucarelli
Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70126 Bari, Italy
Abdal Rahman Abu Farhan
Department of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
Francesco Cantiello
Department of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
Rocco Damiano
Department of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
Rodolfo Hurle
Department of Urology, Istituto Clinico Humanitas Istituto di Ricovero e Cura a Carattere Scientifico-Clinical and Research Hospital, Milan IRCCS, 20089 Milan, Italy
Roberto Contieri
Department of Urology, Istituto Clinico Humanitas Istituto di Ricovero e Cura a Carattere Scientifico-Clinical and Research Hospital, Milan IRCCS, 20089 Milan, Italy
Gian Maria Busetto
Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy
Giuseppe Carrieri
Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy
Luigi Cormio
Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
Francesco Del Giudice
Department of Urology, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
Alessandro Sciarra
Department of Urology, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
Background: A systemic inflammatory marker, the modified Glasgow prognostic score (mGPS), could predict outcomes in non-muscle-invasive bladder cancer (NIMBC). We aimed to investigate the predictive power of mGPS in oncological outcomes in HG/G3 T1 NMIBC patients undergoing Bacillus Calmette–Guérin (BCG) therapy. Methods: We retrospectively reviewed patient’s medical data from multicenter institutions. A total of 1382 patients with HG/G3 T1 NMIBC have been administered adjuvant intravesical BCG therapy, every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months. The analysis of mGPS for recurrence and progression was performed using multivariable and univariable Cox regression models. Results: During follow-up, 659 patients (47.68%) suffered recurrence, 441 (31.91%) suffered progression, 156 (11.28%) died of all causes, and 67 (4.84%) died of bladder cancer. At multivariable analysis, neutrophil to lymphocyte ratio [hazard ratio (HR): 7.471; p = 0.0001] and erythrocyte sedimentation rate (ESR) (HR: 0.706; p = 0.006 were significantly associated with recurrence. mGPS has no statistical significance for progression (p = 0.076). Kaplan–Meier survival analysis showed a significant difference in survival among patients from different mGPS subgroups. Five-year OS was 93% (CI 95% 92–94), in patients with mGPS 0, 82.2% (CI 95% 78.9–85.5) in patients with mGPS 1 and 78.1% (CI 95% 60.4–70) in mGPS 2 patients. Five-year CSS was 98% (CI 95% 97–99) in patients with mGPS 0, 90% (CI 95% 87–94) in patients with mGPS 1, and 100% in mGPS 2 patients. Limitations are applicable to a retrospective study. Conclusions: mGPS may have the potential to predict recurrence in HG/G3 T1 NMIBC patients, but more prospective, with large cohorts, studies are needed to study the influence of systemic inflammatory markers in prediction of outcomes in NMIBC for a definitive conclusion.
