{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:22:33Z","timestamp":1790871753450,"version":"4.1.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Most patients initially diagnosed with non-muscle invasive bladder cancer (NMIBC) still have frequent recurrence after urethral bladder tumor electrodesiccation supplemented with intravesical instillation therapy, and their risk of recurrence is difficult to predict. Risk prediction models used to predict postoperative recurrence in patients with NMIBC have limitations, such as a limited number of included cases and a lack of validation. Therefore, there is an urgent need to develop new models to compensate for the shortcomings and potentially provide evidence for predicting postoperative recurrence in NMIBC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinicopathologic characteristics and follow-up data were retrospectively collected from 556 patients with NMIBC who underwent transurethral resection of bladder tumors by electrocautery (TURBT) from January 2014 to December 2023 at the Affiliated Hospital of Zunyi Medical University and 167 patients with NMIBC who underwent the same procedure from January 2018 to April 2024 at the Third Affiliated Hospital of Zunyi Medical University. Independent risk factors affecting the recurrence of NMIBC were screened using the least absolute shrinkage and selection operator (Lasso) and Cox regression analysis. Cox risk regression models and randomized survival forest (RSF) models were developed. The optimal model was selected by comparing the area under the curve (AUC) of the working characteristics of the subjects in both and presented as a column-line graph.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included data from 566 patients obtained from the affiliated hospital of Zunyi Medical University and 167 patients obtained from the third affiliated hospital of Zunyi Medical University. Tumor number, urine leukocytes, urine occult blood, platelets, and red blood cell distribution width were confirmed as independent risk factors predicting RFS by Lasso-Cox regression analysis. The Cox proportional risk regression model and RSF model were constructed based on Lasso, which showed good predictive efficacy in both training and validation sets, especially the traditional Cox proportional risk regression model. In addition, the discrimination, consistency, and clinical utility of the column-line graph were assessed using C-index, area under the curve (AUC), calibration curve, and decision curve analysis (DCA). Patients at high risk of recurrence can be identified early based on risk stratification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Internal and external validation has demonstrated that the model is highly discriminative and stable and can be used to assess the risk of early recurrence in NMIBC patients and to guide clinical decision-making.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1467527","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T06:13:18Z","timestamp":1736489598000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and external validation of a model to predict recurrence in patients with non-muscle invasive bladder cancer"],"prefix":"10.3389","volume":"15","author":[{"given":"Jiajia","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longmei","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyu","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongrong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinqi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjian","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingshun","family":"Zuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangrong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.eururo.2021.08.010","article-title":"European association of urology guidelines on non-muscle-invasive bladder cancer (Ta, T1, and carcinoma in situ)","volume":"81","author":"Babjuk","year":"2022","journal-title":"Eur Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1038\/nrc3817","article-title":"Molecular biology of bladder cancer: new insights into pathogenesis and clinical diversity","volume":"15","author":"Knowles","year":"2015","journal-title":"Nat Rev Cancer"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21631","article-title":"Treatment of muscle-invasive and advanced bladder cancer in 2020","volume":"70","author":"Patel","year":"2020","journal-title":"CA Cancer J Clin"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2005.12.031","article-title":"Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials","volume":"49","author":"Sylvester","year":"2006","journal-title":"Eur Urol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.07.016","article-title":"Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with bacillus Calmette-Guerin: the CUETO scoring model","volume":"182","author":"Fernandez-Gomez","year":"2009","journal-title":"J Urol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.12.033","article-title":"European association of urology (EAU) prognostic factor risk groups for non-muscle-invasive bladder cancer (NMIBC) incorporating the WHO 2004\/2016 and WHO 1973 classification systems for grade: an update from the EAU NMIBC guidelines panel","volume":"79","author":"Sylvester","year":"2021","journal-title":"Eur Urol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.v9.11","article-title":"Validation of EORTC, CUETO, and EAU risk stratification in prediction of recurrence, progression, and death of patients with initially non-muscle-invasive bladder cancer (NMIBC): A cohort analysis","volume":"9","author":"Jobczyk","year":"2020","journal-title":"Cancer Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.10.019","article-title":"Preoperative abdominal fat distribution and systemic immune inflammation were associated with response to intravesical Bacillus Calmette-Guerin immunotherapy in patients with non-muscle invasive bladder cancer","volume":"40","author":"Ke","year":"2021","journal-title":"Clin Nutr"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1070043","article-title":"Development and external validation of a novel nomogram model for predicting postoperative recurrence-free survival in non-muscle-invasive bladder cancer","volume":"13","author":"Ding","year":"2022","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1032907","article-title":"Preoperative sarcopenia and systemic immune-inflammation index can predict response to intravesical Bacillus Calmette-Guerin instillation in patients with non-muscle invasive bladder cancer","volume":"13","author":"Liu","year":"2022","journal-title":"Front Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16486","article-title":"Prognostic role of the neutrophil\/lymphocyte ratio in high-risk BCG-na\u00efve non-muscle-invasive bladder cancer treated with intravesical gemcitabine\/docetaxel","volume":"135","author":"Chakra","year":"2024","journal-title":"BJU Int"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1101830","article-title":"The different predictive value of mean platelet volume-to-lymphocyte ratio for postoperative recurrence between non-muscular invasive bladder cancer patients treated with intravesical chemotherapy and intravesical chemohyperthermia","volume":"12","author":"Wang","year":"2022","journal-title":"Front Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2017.03.007","article-title":"Prognostic role of neutrophil-to-lymphocyte ratio in primary non-muscle-invasive bladder cancer","volume":"15","author":"D'andrea","year":"2017","journal-title":"Clin Genitourin Cancer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1160\/TH14-12-1067","article-title":"The role of platelets in inflammation","volume":"114","author":"Thomas","year":"2015","journal-title":"Thromb Haemost"},{"key":"B15","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1186\/s13045-018-0669-2","article-title":"Role of platelets and platelet receptors in cancer metastasis","volume":"11","author":"Schlesinger","year":"2018","journal-title":"J Hematol Oncol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2789","DOI":"10.3390\/jcm13102789","article-title":"Development and internal validation of nomograms for survival of advanced epithelial ovarian cancer based on established prognostic factors and hematologic parameters","volume":"13","author":"Said","year":"2024","journal-title":"J Clin Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"11927","DOI":"10.3390\/ijms241511927","article-title":"Pro-tumorigenic and thrombotic activities of platelets in lung cancer","volume":"24","author":"Anderson","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B18","doi-asserted-by":"publisher","first-page":"166280","DOI":"10.1016\/j.bbadis.2021.166280","article-title":"Platelet-dependent signaling and Low Molecular Weight Protein Tyrosine Phosphatase expression promote aggressive phenotypic changes in gastrointestinal cancer cells","volume":"1868","author":"Faria","year":"2022","journal-title":"Biochim Biophys Acta Mol Basis Dis"},{"key":"B19","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1007\/s00345-024-05148-1","article-title":"Preoperative blood-based nutritional biomarkers as significant prognostic factors after intravesical BCG therapy in patients with non-muscle-invasive bladder cancer","volume":"42","author":"Ye","year":"2024","journal-title":"World J Urol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"3764","DOI":"10.3390\/jcm10173764","article-title":"Pyuria as a predictive marker of bacillus calmette-gu\u00e9rin unresponsiveness in non-muscle invasive bladder cancer","volume":"10","author":"Suh","year":"2021","journal-title":"J Clin Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2013.04.002","article-title":"Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer","volume":"11","author":"Azuma","year":"2013","journal-title":"Clin Genitourin Cancer"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/iju.2015.22.issue-7","article-title":"Prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer","volume":"22","author":"Satake","year":"2015","journal-title":"Int J Urol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2581-3","article-title":"Novel nomograms to predict recurrence and progression in primary non-muscle-invasive bladder cancer: validation of predictive efficacy in comparison with European Organization of Research and Treatment of Cancer scoring system","volume":"37","author":"Kim","year":"2019","journal-title":"World J Urol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s12894-024-01437-4","article-title":"Nomogram for customized recurrence prediction in primary non-muscle-invasive bladder cancer based on routine blood and urine parameters","volume":"24","author":"He","year":"2024","journal-title":"BMC Urol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-076743","article-title":"Advances in diagnosis and treatment of bladder cancer","volume":"384","author":"Lopez-Beltran","year":"2024","journal-title":"BMJ"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002625","article-title":"Risk factors predictive of recurrence and progression for patients who suffered initial recurrence after transurethral resection of stage pT1 bladder tumor in chinese population: A retrospective study","volume":"95","author":"Shen","year":"2016","journal-title":"Med (Baltimore)"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.06.028","article-title":"Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy","volume":"56","author":"Van Rhijn","year":"2009","journal-title":"Eur Urol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1080\/09537104.2019.1686755","article-title":"The predictive role of thrombocytosis in benign, borderline and Malignant ovarian tumors","volume":"31","author":"Abdulrahman","year":"2020","journal-title":"Platelets"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.20452\/pamw.4299","article-title":"Preoperative thrombocytosis in surgically treated patients with non-small cell lung cancer","volume":"128","author":"Skorek","year":"2018","journal-title":"Pol Arch Intern Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i18.5607","article-title":"Significance of platelet count and platelet-based models for hepatocellular carcinoma recurrence","volume":"21","author":"Pang","year":"2015","journal-title":"World J Gastroenterol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1342244","article-title":"Development and validation of a nomogram to predict lymph node metastasis in patients with progressive muscle-invasive bladder cancer","volume":"14","author":"Qiao","year":"2024","journal-title":"Front Oncol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"3984","DOI":"10.3390\/cancers15153984","article-title":"Clinical relevance of red blood cell distribution width (RDW) in endometrial cancer: A retrospective single-center experience from korea","volume":"15","author":"Eoh","year":"2023","journal-title":"Cancers (Basel)"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1080\/1354750X.2020.1731763","article-title":"Prognostic value of pre-treatment red blood cell distribution width in lung cancer: a meta-analysis","volume":"25","author":"Wang","year":"2020","journal-title":"Biomarkers"},{"key":"B34","doi-asserted-by":"publisher","first-page":"101486","DOI":"10.1016\/j.tranon.2022.101486","article-title":"Preoperative red blood cell distribution width as an independent prognostic factor in metastatic renal cell carcinoma","volume":"23","author":"Wei","year":"2022","journal-title":"Transl Oncol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"31","DOI":"10.17219\/acem\/152635","article-title":"High red blood cell distribution width is associated with the mortality of critically ill cancer patients: A propensity-matching study","volume":"32","author":"Zhou","year":"2023","journal-title":"Adv Clin Exp Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14118","article-title":"Prognostic value of preoperative inflammation markers in non-muscle invasive bladder cancer","volume":"75","author":"Yildiz","year":"2021","journal-title":"Int J Clin Pract"},{"key":"B37","doi-asserted-by":"publisher","first-page":"295","DOI":"10.21037\/tau.2020.03.08","article-title":"Prognostic significance of red cell distribution width in bladder cancer","volume":"9","author":"Ma","year":"2020","journal-title":"Transl Androl Urol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"638.e15","DOI":"10.1016\/j.urolonc.2020.01.016","article-title":"Red cell distribution width predicts time to recurrence in patients with primary non-muscle-invasive bladder cancer and improves the accuracy of the EORTC scoring system","volume":"38","author":"Fukuokaya","year":"2020","journal-title":"Urol Oncol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"796975","DOI":"10.3389\/fonc.2021.796975","article-title":"Can routine blood and urine parameters reveal clues to detect bladder cancer? A case-control study","volume":"11","author":"Wang","year":"2021","journal-title":"Front Oncol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-22-1220","article-title":"The DNA damage response and inflammation in cancer","volume":"13","author":"Klapp","year":"2023","journal-title":"Cancer Discovery"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.07.033","article-title":"Inflammatory biomarkers and bladder cancer prognosis: a systematic review","volume":"66","author":"Masson-Lecomte","year":"2014","journal-title":"Eur Urol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1038\/s41388-022-02322-w","article-title":"Exosomal miR-4466 from nicotine-activated neutrophils promotes tumor cell stemness and metabolism in lung cancer metastasis","volume":"41","author":"Tyagi","year":"2022","journal-title":"Oncogene"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2016.1265719","article-title":"High baseline levels of interleukin-8 in leukocytes and urine predict tumor recurrence in non-muscle invasive bladder cancer patients receiving bacillus Calmette-Guerin therapy: A long-term survival analysis","volume":"6","author":"Qu","year":"2017","journal-title":"Oncoimmunology"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1467527\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T06:13:22Z","timestamp":1736489602000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1467527\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,10]]},"references-count":43,"alternative-id":["10.3389\/fimmu.2024.1467527"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2024.1467527","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,10]]},"article-number":"1467527"}}