Effect of platelet-lymphocyte ratio on recurrence rate and recurrence duration in non muscle invasive bladder cancer patients treated with intravesical BCG (bacillus calmette-guerin) and intravesical thermochemotherapy

Aim: The purpose of study was to determine the effect of platelet-to-lymphocyte ratio (PLR) for number of recurrence and frequency in non-muscle invasive bladder cancer who theated with intravesical immunotherapy or thermochemotherapy. Materials and Methods: A total of 153 patients who underwent transurethral tumor resection between 2020–20024 and followed up to 48 months were retrospectively analyzed. Patients were evaluated according to pathology results by dividing them into groups as Ta and T1, high grade or low grade, CIS positive or negative. Conditions such as age, gender, smoking status, comorbidities, and variant pathology association were examined. They were divided into groups as those who developed recurrence and those who did not during follow-up and were evaluated. The time until relapse was evaluated as Recurrence Free Survival (RFS).Preoperative test results including platelet and lymphocyte count were used to calculate PLR. Patients with active infection at the time of admission, patients with hematological or rheumatological disease, and patients with missing information in their files were excluded from the study. Results: According to the ROC curve, the threshold value of the PLR rate for recurrence was calculated as 120. A significant difference was found between the patient groups with PLR ratio higher and lower than 120 in terms of recurrence-free survival in both BCG (Bacıllus-Calmette-Guerın) and Thermochemotherapy (TKT) groups (p<0.001, p=0.020). Continuation of smoking in both groups (p<0.001, p<0.001), presence of variant pathology in the group receiving BCG (p=0.008) Additionally, in the TCT group, tumor stage T1 increased the number of recurrences (p<0.001). In multivariate variant analysis, it was observed that high PLR increased the number of relapses and shortened the time to recurrence in both groups (p = 0.038). Conclusion: In our study, preoperative Platelet-Lymphocyte Ratio was found to be an independent predictive factor for the number and duration of recurrence in both intravesical BCG and TCT groups in non-muscle invasive bladder cancer. Use of this biomarker in combination with other diagnostic/predictive tools may assist urologists in clinical decision-making in the future. Keywords: KİOMK, BCG, Thermochemotherpy, Platelet-Lenfosit Ratio