Basophils, eosinophils and monocytes may be involved in BCG-induced immune responses and be associated with outcomes of bladder cancer patients receiving intravesical BCG. Our objective was to explore the association of baseline counts of basophils, eosinophils and monocytes with outcomes of patients with high-grade T1 bladder cancer receiving a standard course of intravesical BCG.
We retrospectively reviewed medical records of patients with primary T1 HG/G3 bladder cancer. After re-TURBT, patients were treated with a 6-week course of intravesical BCG induction followed by intravesical BCG every week for 3 weeks given at 3, 6, 12, 18, 24, 30 and 36 months from initiation of therapy The analysis of potential risk factors for recurrence, muscle invasion and cancer-specific and overall survival was performed using univariable Cox regression models. Those factors that presented, at univariate analysis, an association with the event at a liberal p < 0.1, have been selected for the development of a multivariable model.
A total of 1045 patients with primary T1 HG/G3 were included. A total of 678 (64.9%) recurrences, 303 (29.0%) progressions and 150 (14.3%) deaths were observed during follow-up. Multivariate analysis showed that logarithmic transformation of basophils count was associated with a 30% increment in the hazard of recurrence per unit increase of logarithmic basophils count (HR 1.30; 95% confidence interval 1.09-1.54; p = 0.0026). Basophil count modeled by quartiles was also significantly associated with time to recurrence [second vs. lower quartile HR 1.42 (1.12-1.79); p = 0.003, third vs. lower quartile HR 1.26 (1.01-1.57); p = 0.041; upper vs. lower quartile HR 1.36 (1.1-1.68); p = 0.005]. The limitations of a retrospective study are applicable.
Baseline basophil count may predict recurrence in BCG-treated HG/G3 T1 bladder cancer patients. External validation is warranted.
World journal of urology. 2019 Apr 16 [Epub ahead of print]
M Ferro, G Di Lorenzo, M D Vartolomei, D Bruzzese, F Cantiello, G Lucarelli, G Musi, S Di Stasi, R Hurle, G Guazzoni, G M Busetto, A Gabriele, F Del Giudice, R Damiano, F Perri, S Perdona, P Verze, M Borghesi, R Schiavina, G L Almeida, P Bove, E Lima, R Autorino, N Crisan, A R Abu Farhan, M Battaglia, G I Russo, Vincenzo Ieluzzi, G Morgia, P De Placido, D Terracciano, A Cimmino, L Scafuri, V Mirone, O De Cobelli, S Shariat, Guru Sonpavde, C Buonerba
Division of Urology, European Institute of Oncology, via Ripamonti 435, Milan, Italy. ., Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy., Division of Urology, European Institute of Oncology, via Ripamonti 435, Milan, Italy., Department of Public Health, Federico II University of Naples, Naples, Italy., Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy., Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy., Department of Experimental Medicine and Surgery, Tor Vegata University, Rome, Italy., Department of Urology, Istituto Clinico Humanitas Istituto di Ricovero e Cura a Carattere Scientifico-Clinical and Research Hospital, Milan, Italy., Department of Biomedical Science, Humanitas University, Milan, Rozzano, Italy., Department of Urology, Sapienza University of Rome, Rome, Italy., Uro-Gynecological Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale" IRCCS, Naples, Italy., Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II", Naples, Italy., Department of Urology, University of Bologna, Bologna, Italy., Departamento de Urologia, University of Vale do Itajaí, Itajaí, Brazil., Division of Urology, Department of Experimental Medicine and Surgery, Urology Unit, Tor Vergata University of Rome, Rome, Italy., Life and Health Sciences Research Institute, University of Minho, Braga, Portugal., Division of Urology, Virginia Commonwealth University, Richmond, VA, USA., Department of Urology, University of Medicine and Pharmacy "Iuliu Haţeganu,", Cluj-Napoca, Romania., Department of Urology, University of Catania, Catania, Italy., Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy., Institute of Genetics and Biophysics "A. Buzzati-Traverso", CNR, Naples, Italy., Department of Urology, Medical University of Vienna, Vienna, Austria., Dana-Farber Cancer Institute, GU Oncology Division, Harvard Medical School, Boston, MA, USA.