RESUMO
PURPOSE: To evaluate the association between preoperative pan-immune inflammation value (PIV) and overall survival (OS) and disease-free survival (DFS) in patients who underwent radical cystectomy for non-metastatic muscle-invasive bladder cancer. METHODS: A total of 119 patients with non-metastatic muscle-invasive bladder cancer who underwent radical cystectomy at our institution between January 2014 and January 2022 were included in this retrospective study. PIV was calculated using the formula (monocyte count × neutrophil count × platelet count)/lymphocyte count. Ideal cut-off values for PIV were determined using ROC curve analysis. Kaplan-Meier analysis was used to evaluate the impact of PIV on survival outcomes. RESULTS: The mean age of patients was 65 ± 14 years, and the mean follow-up duration was 36 months. The ideal cutoff value for PIV was determined to be 406.29, and a PIV above this value was associated with poorer OS (p < 0.001) (73 months vs. 21 months) and DFS (p = 0.002) (35 months vs 19 months). Higher neutrophil-to-lymphocyte ratio (NLR) values were also associated with poorer OS (p < 0.001) and DFS (p < 0.001), with similar effectiveness to PIV. PIV was found to be significantly more effective than platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) in predicting DFS. CONCLUSION: Preoperative PIV may serve as an independent prognostic factor for OS in patients who undergo radical cystectomy with non-metastatic muscle-invasive bladder cancer. A high PIV value was associated with poorer survival outcomes. Prospective multicenter studies are needed to further validate the relationship between PIV and histopathological features of bladder cancer.
