Özet:

Objective: We aimed to investigate the predictive value of additional parameters that may improve diagnostic accuracy in predicting extravesical tumor invasion in patients with muscle invasive transitional cell carcinoma after transurethral bladder tumor resection (TUR-BT). Material and Methods: The data of patients with muscle-invasive bladder tumor pathology on TUR-BT and who underwent radical cystectomy between January 2009 and December 2016 due to clinical stage T2 or T3 were evaluated retrospectively. Demographic, pathological and clinical data were recorded. Patients were divided into two groups after pathological staging following radical cystectomy: 26 patients without extravesical tumor invasion (pT2) and 17 patients with extravesical tumor invasion (pT3). Results: Of the patients with a median age of 65, 40 (93%) were male and 3 (7%) were female.ECOG score,ASA score, Charlson comorbidity index(CCI), neutrophil/lymphocyte ratio(NLR), platelet/lymphocyte ratio(PLR), monocyte/lymphocyte ratio(MLR), average platelet volume(MPV), presence of preoperative hydronephrosis, concomitant carcinoma in situ(CIS), lymphovascular invasion(LVI), depth of invasion in muscularis propria>50%, history of previous tumor recurrence were significantly higher in Group II. In multivariate analysis, hydronephrosis, previous recurrence, presence of LVI, depth of invasion in muscularis propria>50%, eGFR, NLR, PLR and MLR were found to be independent predictors in predicting extravesical invasion. According to ROC analysis, cut-off values for eGFR, MLR, PLR, NLR were 77.73 (AUC:0.805, p=0.001), 0.24 (AUC:0.771, p=0.003), 116 (AUC:0.766, p=0.004), 2.07 (AUC:0.710, p=0.021), respectively. Conclusion: We think that diagnostic accuracy in clinical staging before radical cystectomy may be improved by using additional parameters other than CT or MRG.

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