KEMAL KAYAR, RIDVAN KAYAR, BUĞRAHAN BUHUR ÖZDEMİR, İLKER ARTUK, EMRE TOKUÇ, ÇAĞATAY TOSUN, METİN İSHAK ÖZTÜRK, ÖMER ERGİN YÜCEBAŞ
The New Journal of Urology - 2025;20(2):104-112
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 highrisk 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.
