Preoperative Systemic Inflammatory Indices (SII, SIRI and PIV) Associated with Adverse Histology and 12-Month Recurrence After Transurethral Resection of Non-Muscle-Invasive Bladder Cancer
6 affiliations
- 1Department of Urology, University of Medicine and Pharmacy of Craiova, 2 Petru Rareș Street, 200349 Craiova, Romania
- 2Department of Dermatology, University of Medicine and Pharmacy of Craiova, 2 Petru Rareș Street, 200349 Craiova, Romania
- 3Department of Urology, County Emergency Hospital of Târgu-Jiu, 18 Progresului Street, 210218 Târgu-Jiu, Romania
- 4Department of Surgical Oncology, University of Medicine and Pharmacy of Craiova, 2 Petru Rareș Street, 200349 Craiova, Romania
- 5Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, 2 Petru Rareș Street, 200349 Craiova, Romania
- 6Department of Cardiology, University of Medicine and Pharmacy of Craiova, 2 Petru Rareș Street, 200349 Craiova, Romania
Abstract
Background/Objectives: Non-muscle-invasive bladder cancer (NMIBC) recurs frequently, and clinicopathological tools predict recurrence imperfectly. We assessed whether six preoperative blood-count-derived inflammatory indices (SII, SIRI, PIV, NLR, PLR, and LMR) are associated with adverse histology and 12-month recurrence and whether SIRI adds prognostic information to established risk factors. Methods: We retrospectively analysed 180 consecutive NMIBC patients treated by transurethral resection of bladder tumour (TURBT) and immediate instillation. Indices were modelled per 1-SD in logistic (adverse histology: high grade, T1 or carcinoma in situ) and Cox (recurrence) models adjusted for established risk factors. Results: Adverse histology occurred in 121 patients (67.2%); 88 recurred (12-month Kaplan–Meier estimate: 49.2%). All six indices were univariably associated with both endpoints, with similar effects (SIRI: adverse histology OR: 2.35, 95% CI: 1.41–3.90; recurrence HR: 1.41, 1.19–1.67). After adjustment, SIRI was not independently associated with adverse histology (OR: 1.69, 0.92–3.11) or recurrence (HR: 1.10, 0.86–1.40) and did not improve discrimination (ΔC: 0.001, −0.006 to 0.016). Results were robust across sensitivity analyses, including propensity weighting for BCG (limited by positivity violations). Conclusions: SIRI added no demonstrable independent prognostic value. Given modest overfitting (optimism-corrected calibration slope: 0.79), neither the indices nor the model should be used clinically without external validation and recalibration.
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BibTeX
@article{vasile2026preoperative,
title = {{Preoperative Systemic Inflammatory Indices (SII, SIRI and PIV) Associated with Adverse Histology and 12-Month Recurrence After Transurethral Resection of Non-Muscle-Invasive Bladder Cancer}},
author = {Dragoș Florin Vasile and Mihnea Meșină and George G. Mitroi and Alexandru-Daniel Danilă and Cosmin Vasile Obleaga and Mihai Alexandru Radu and Georgică Târtea and George F. Mitroi},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218536},
url = {https://www.mdpi.com/2077-0383/15/21/8536},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Preoperative Systemic Inflammatory Indices (SII, SIRI and PIV) Associated with Adverse Histology and 12-Month Recurrence After Transurethral Resection of Non-Muscle-Invasive Bladder Cancer
AU - Dragoș Florin Vasile
AU - Mihnea Meșină
AU - George G. Mitroi
AU - Alexandru-Daniel Danilă
AU - Cosmin Vasile Obleaga
AU - Mihai Alexandru Radu
AU - Georgică Târtea
AU - George F. Mitroi
PY - 2026
DA - 2026/11/02
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218536
UR - https://www.mdpi.com/2077-0383/15/21/8536
AB - Background/Objectives: Non-muscle-invasive bladder cancer (NMIBC) recurs frequently, and clinicopathological tools predict recurrence imperfectly. We assessed whether six preoperative blood-count-derived inflammatory indices (SII, SIRI, PIV, NLR, PLR, and LMR) are associated with adverse histology and 12-month recurrence and whether SIRI adds prognostic information to established risk factors. Methods: We retrospectively analysed 180 consecutive NMIBC patients treated by transurethral resection of bladder tumour (TURBT) and immediate instillation. Indices were modelled per 1-SD in logistic (adverse histology: high grade, T1 or carcinoma in situ) and Cox (recurrence) models adjusted for established risk factors. Results: Adverse histology occurred in 121 patients (67.2%); 88 recurred (12-month Kaplan–Meier estimate: 49.2%). All six indices were univariably associated with both endpoints, with similar effects (SIRI: adverse histology OR: 2.35, 95% CI: 1.41–3.90; recurrence HR: 1.41, 1.19–1.67). After adjustment, SIRI was not independently associated with adverse histology (OR: 1.69, 0.92–3.11) or recurrence (HR: 1.10, 0.86–1.40) and did not improve discrimination (ΔC: 0.001, −0.006 to 0.016). Results were robust across sensitivity analyses, including propensity weighting for BCG (limited by positivity violations). Conclusions: SIRI added no demonstrable independent prognostic value. Given modest overfitting (optimism-corrected calibration slope: 0.79), neither the indices nor the model should be used clinically without external validation and recalibration.
SN - 2077-0383
ER -