{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:15:53Z","timestamp":1789398953851,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Urothelial carcinoma of the bladder (UCB) demonstrates considerable heterogeneity, with markedly varying outcomes between non\u2013muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). The pan-immune-inflammation value (PIV), derived from routine hematological parameters, has emerged as a novel biomarker reflecting systemic inflammation and immune dysregulation. This pilot, exploratory analysis evaluated the prognostic relevance of the PIV in UCB and contextualized PIV against other inflammation-based indices. Methods: We retrospectively analyzed 119 patients with histologically confirmed UCB who were treated between 2019 and 2024. PIV was calculated as (neutrophils \u00d7 platelets \u00d7 monocytes) \u00f7 lymphocytes. Additional indices included the NLR, SII, SIRI, and PLR. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan\u2013Meier analysis, and prognostic factors were assessed using Cox regression. Results: Among 119 patients (median age, 72 years; 88% male), 68 were diagnosed with NMIBC and 51 with MIBC. Elevated PIV levels were significantly associated with NMIBC progression to MIBC (p = 0.028) and strongly correlated with NLR, SII, SIRI, and PLR. Patients with high PIV exhibited shorter OS (24 vs. 45 months) and PFS (20 vs. 35 months) than those with low patients (p &lt; 0.001). Although the prognostic value was evident in the univariate analyses, PIV did not retain significance in multivariate models. Conclusion: Elevated PIV levels predict adverse survival outcomes and progression in UCB, underscoring its potential as a cost-effective and accessible biomarker for risk stratification. Prospective validation in larger cohorts is warranted to confirm its role in personalized patient management.<\/jats:p>","DOI":"10.3390\/curroncol32100534","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T08:56:44Z","timestamp":1758790604000},"page":"534","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pan-Immune-Inflammation Value as a Predictor of Long-Term Outcomes in Patients with Urothelial Carcinoma of the Bladder: A Pilot Study"],"prefix":"10.3390","volume":"32","author":[{"given":"Ali Erhan","family":"Eren","sequence":"first","affiliation":[{"name":"Department of Urology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-9825","authenticated-orcid":false,"given":"Asim Armagan","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1074-1016","authenticated-orcid":false,"given":"Eren Erdi","family":"Aksaray","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0159-2497","authenticated-orcid":false,"given":"Arda","family":"Durak","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6654-3815","authenticated-orcid":false,"given":"Ahmet","family":"Unlu","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0693-0666","authenticated-orcid":false,"given":"Mahmut Ekrem","family":"Islamoglu","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banu","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Yildiz","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, University of Health Sciences Antalya Education and Research Hospital, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1001\/jama.2020.17598","article-title":"Bladder Cancer: A Review","volume":"324","author":"Lenis","year":"2020","journal-title":"JAMA"},{"key":"ref_2","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1038\/s41572-023-00468-9","article-title":"Bladder Cancer","volume":"9","author":"Hansel","year":"2023","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1016\/S0140-6736(22)01188-6","article-title":"Current Best Practice for Bladder Cancer: A Narrative Review of Diagnostics and Treatments","volume":"400","author":"Amin","year":"2022","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1038\/s41585-023-00847-7","article-title":"Molecular Profile of Bladder Cancer Progression to Clinically Aggressive Subtypes","volume":"21","author":"Guo","year":"2024","journal-title":"Nat. Rev. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1056\/NEJMoa2408154","article-title":"Perioperative Durvalumab with Neoadjuvant Chemotherapy in Operable Bladder Cancer","volume":"391","author":"Powles","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1056\/NEJMoa2312117","article-title":"Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial Cancer","volume":"390","author":"Powles","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1038\/s41585-024-00963-y","article-title":"Metastasis Development in Non-Muscle-Invasive Bladder Cancer","volume":"22","author":"Leyderman","year":"2025","journal-title":"Nat. Rev. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.eururo.2025.02.019","article-title":"European Association of Urology Guidelines on Muscle-Invasive and Metastatic Bladder Cancer: Summary of the 2025 Guidelines","volume":"87","author":"Bruins","year":"2025","journal-title":"Eur. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1038\/s41416-020-0894-7","article-title":"The Pan-Immune-Inflammation Value Is a New Prognostic Biomarker in Metastatic Colorectal Cancer: Results from a Pooled-Analysis of the Valentino and TRIBE First-Line Trials","volume":"123","author":"Guarini","year":"2020","journal-title":"Br. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.trecan.2021.11.010","article-title":"Immune Response and Inflammation in Cancer Health Disparities","volume":"8","author":"Kiely","year":"2022","journal-title":"Trends Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1038\/s41577-021-00571-6","article-title":"Neutrophils in Cancer: Heterogeneous and Multifaceted","volume":"22","author":"Hedrick","year":"2022","journal-title":"Nat. Rev. Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Patysheva, M., Frolova, A., Larionova, I., Afanas\u2019ev, S., Tarasova, A., Cherdyntseva, N., and Kzhyshkowska, J. (2022). Monocyte Programming by Cancer Therapy. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.994319"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1161\/CIRCRESAHA.122.321861","article-title":"Mechanism of Tumor-Platelet Communications in Cancer","volume":"132","author":"Dudiki","year":"2023","journal-title":"Circ. Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Sheu, T.-T., and Chiang, B.-L. (2021). Lymphopenia, Lymphopenia-Induced Proliferation, and Autoimmunity. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22084152"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3329","DOI":"10.2147\/JIR.S418276","article-title":"Pan-Immune-Inflammatory Value in Patients with Non-Small-Cell Lung Cancer Undergoing Neoadjuvant Immunochemotherapy","volume":"16","author":"Zhai","year":"2023","journal-title":"J. Inflamm. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Qi, X., Qiao, B., Song, T., Huang, D., Zhang, H., Liu, Y., Jin, Q., Yang, M., and Liu, D. (2023). Clinical Utility of the Pan-Immune-Inflammation Value in Breast Cancer Patients. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1223786"},{"key":"ref_18","first-page":"e71251","article-title":"Pan-Immune-Inflammation Value as a Novel Prognostic Biomarker for Advanced Pancreatic Cancer","volume":"16","author":"Aydin","year":"2024","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Li, J., Cao, D., Huang, Y., Xiong, Q., Tan, D., Liu, L., Lin, T., and Wei, Q. (2022). The Prognostic and Clinicopathological Significance of Systemic Immune-Inflammation Index in Bladder Cancer. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.865643"},{"key":"ref_20","first-page":"256.e1","article-title":"The Systemic Inflammation Response Index: An Independent Predictive Factor for Survival Outcomes of Bladder Cancer Stronger than Other Inflammatory Markers","volume":"41","author":"Yilmaz","year":"2023","journal-title":"Urol. Oncol. Semin. Orig. Investig."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Wang, X., Ni, X., and Tang, G. (2019). Prognostic Role of Platelet-to-Lymphocyte Ratio in Patients With Bladder Cancer: A Meta-Analysis. Front. Oncol., 9.","DOI":"10.3389\/fonc.2019.00757"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s10147-017-1171-5","article-title":"The Clinical Use of Neutrophil-to-Lymphocyte Ratio in Bladder Cancer Patients: A Systematic Review and Meta-Analysis","volume":"22","author":"Tang","year":"2017","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Nishida, A., and Andoh, A. (2025). The Role of Inflammation in Cancer: Mechanisms of Tumor Initiation, Progression, and Metastasis. Cells, 14.","DOI":"10.3390\/cells14070488"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s12943-025-02243-8","article-title":"Inflammation in Cancer: Therapeutic Opportunities from New Insights","volume":"24","author":"Xie","year":"2025","journal-title":"Mol. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1346094","DOI":"10.1155\/2022\/1346094","article-title":"Pretreatment Pan-Immune-Inflammation Value Efficiently Predicts Survival Outcomes in Glioblastoma Multiforme Patients Receiving Radiotherapy and Temozolomide","volume":"2022","author":"Topkan","year":"2022","journal-title":"J. Immunol. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2355279","DOI":"10.1080\/02656736.2024.2355279","article-title":"Prognostic Significance of Pan-Immune-Inflammation Value in Hepatocellular Carcinoma Treated by Curative Radiofrequency Ablation: Potential Role for Individualized Adjuvant Systemic Treatment","volume":"41","author":"Liang","year":"2024","journal-title":"Int. J. Hyperth."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s11255-023-03812-w","article-title":"Pan-Immune-Inflammation Value as a Prognostic Tool for Overall Survival and Disease-Free Survival in Non-Metastatic Muscle-Invasive Bladder Cancer","volume":"56","author":"Kayar","year":"2023","journal-title":"Int. Urol. Nephrol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Russo, P., Marino, F., Rossi, F., Bizzarri, F.P., Ragonese, M., Dibitetto, F., Filomena, G.B., Marafon, D.P., Ciccarese, C., and Iacovelli, R. (2023). Is Systemic Immune-Inflammation Index a Real Non-Invasive Biomarker to Predict Oncological Outcomes in Patients Eligible for Radical Cystectomy?. Medicina, 59.","DOI":"10.3390\/medicina59122063"},{"key":"ref_29","first-page":"393.e1","article-title":"SIRI as a Biomarker for Bladder Neoplasm: Utilizing Decision Curve Analysis to Evaluate Clinical Net Benefit","volume":"43","author":"Russo","year":"2025","journal-title":"Urol. Oncol. Semin. Orig. Investig."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/534\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:49:09Z","timestamp":1760035749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/32\/10\/534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,24]]},"references-count":29,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["curroncol32100534"],"URL":"https:\/\/doi.org\/10.3390\/curroncol32100534","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,24]]}}}