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Research Article

A Novel Technique for Relocating Renal Lower Calyceal Stones During Retrograde Intrarenal Surgery: ‘’Jab and Pull’’


1 Department of Urology, Medical School, Kafkas University, Kars, Türkiye
2 Department of Urology, Medical School, Bahcesehir University, İstanbul, Türkiye
3 Department of Urology, Sancaktepe Şehit Prof Dr Ilhan Varank Training and Research Hospital, İstanbul, Türkiye
 


DOI : 10.33719/nju1339275
New J Urol. 2024;19(1):1-7.

Abstract

Objective: In order to evaluate the predictive role of novel hematologic markers in recurrence and progression among non-muscle invasive bladder cancer (NMIBC) patients undergoing intravesical BCG therapy.

Material and Methods: A total of 182 patients diagnosed with NMIBC and treated with transurethral resection of bladder tumor (TUR-BT) followed by BCG therapy were included. Patients were stratified into intermediate-, high- and very high-risk groups per the EAU 2024 guidelines. Preoperative hematologic parameters were recorded. In addition, CLR, CAR, and IBI were calculated. Recurrence and progression were assessed through follow-up cystoscopies. ROC curve analysis was used to determine the predictive value of the biomarkers.

Results: Recurrence and progression occurred in 15% and 8% of patients, respectively. Multifocal tumors showed a notable association with recurrence (p = 0.006), and carcinoma in situ (CIS) predicted progression (p < 0.001). CAR (AUC = 0.695, p = 0.013) and CLR (AUC = 0.660, p = 0.040) significantly predicted progression. IBI was a strong predictor in the very high-risk group (AUC = 0.920, p < 0.001).

Conclusion: CLR, CAR, and IBI are promising markers for identifying patients at higher risk of progression during BCG therapy. IBI shows strong prognostic utility in very high-risk NMIBC patients. Further prospective, multicenter studies are needed for clinical validation.


Abstract

Objective: In order to evaluate the predictive role of novel hematologic markers in recurrence and progression among non-muscle invasive bladder cancer (NMIBC) patients undergoing intravesical BCG therapy.

Material and Methods: A total of 182 patients diagnosed with NMIBC and treated with transurethral resection of bladder tumor (TUR-BT) followed by BCG therapy were included. Patients were stratified into intermediate-, high- and very high-risk groups per the EAU 2024 guidelines. Preoperative hematologic parameters were recorded. In addition, CLR, CAR, and IBI were calculated. Recurrence and progression were assessed through follow-up cystoscopies. ROC curve analysis was used to determine the predictive value of the biomarkers.

Results: Recurrence and progression occurred in 15% and 8% of patients, respectively. Multifocal tumors showed a notable association with recurrence (p = 0.006), and carcinoma in situ (CIS) predicted progression (p < 0.001). CAR (AUC = 0.695, p = 0.013) and CLR (AUC = 0.660, p = 0.040) significantly predicted progression. IBI was a strong predictor in the very high-risk group (AUC = 0.920, p < 0.001).

Conclusion: CLR, CAR, and IBI are promising markers for identifying patients at higher risk of progression during BCG therapy. IBI shows strong prognostic utility in very high-risk NMIBC patients. Further prospective, multicenter studies are needed for clinical validation.