Neutrophils to Lymphocytes Ratio in Predicting the Response to BCG in Non-muscle Invasive Bladder Cancer

NCT ID: NCT05946369

Last Updated: 2023-07-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

96 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-05-01

Study Completion Date

2023-05-01

Brief Summary

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There is a relation between inflammatory cells and the prognosis of tumors (cancer colon, renal, liver, and urinary bladder).

In this study, the investigators will link the Neutrophils to Lymphocytes ratio to the response to intravesical BCG therapy post trans-urethral resection of urinary bladder tumors for the non-invasive urinary bladder tumors.

Detailed Description

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The gold standard treatment for non-invasive urinary bladder tumors is by transurethral resection of bladder tumor (TURBT) and a re-TURBT when indicated, followed by adjuvant intravesical immunotherapy (BCG). However, the recurrence and progression rates of non-muscle invasive bladder cancer (NMIBC) for 5 years range from 31% to 78% and from 1% to 45%, respectively.

To improve personalized care, prognostic models have been developed to help in prediction of the high-risk patients and recurrence helping in clinical and therapeutic decision-making. These models are based on standard clinic-pathological features such as T stage, grade, multifocality, sex, tumor diameter, recurrence rate, and concomitant carcinoma in situ.

According to the current theories, the systemic inflammatory response triggered by cancer leads to relative neutrophilia and lymphocytopenia, creating a pro-oncogenic inflammatory condition. An elevated NLR (Neutrophil to lymphocyte ratio) implies that cell-mediated immunity is impaired and systemic inflammation is increased in inflammatory processes. Among patients with non-invasive urinary bladder tumors, an elevated NLR (Neutrophil to lymphocyte ratio) was described in the literature to be associated with advanced pathologic stage, invasiveness, and bad prognosis.

The study aims to assess the role of preoperative Neutrophils to Lymphocytes ratio as a predictor for the response to BCG in patients with non-muscle invasive bladder cancer in patients following trans-urethral resection of bladder tumor (TURBT).

Conditions

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Urinary Bladder Cancer Urinary Bladder Neoplasm BCG Trans Urethral Resection of a Bladder Tumor Non-Muscle Invasive Bladder Urothelial Carcinoma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Neutrophil to lymphocyte ratio less than 3

Patients are classified into 2 groups according to NLR \< or ≥ 3 and follow up the 2 groups for recurrence or regression of bladder urothelial tumor and documentation of BCG failure

Neutrophil to lymphocyte ratio

Intervention Type DIAGNOSTIC_TEST

Complete blood count with differential to evaluate the Neutrophil to lymphocyte ratio for each patient

Neutrophil to lymphocyte ration more than or equal 3

Patients are classified into 2 groups according to NLR \< or ≥ 3 and follow up the 2 groups for recurrence or regression of bladder urothelial tumor and documentation of BCG failure

Neutrophil to lymphocyte ratio

Intervention Type DIAGNOSTIC_TEST

Complete blood count with differential to evaluate the Neutrophil to lymphocyte ratio for each patient

Interventions

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Neutrophil to lymphocyte ratio

Complete blood count with differential to evaluate the Neutrophil to lymphocyte ratio for each patient

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Patients with non-muscle invasive urothelial tumor of the urinary bladder

Exclusion Criteria

1. Concomitant malignancy.
2. Hematological disorders.
3. History of radiation or chemotherapy.
4. Concomitant infection or chronic inflammatory diseases.
5. Missing preoperative differential blood cell count.
6. Patients with low grade non muscle invasive Urinary baldder tumors.
7. Patients missing BCG after biopsy revealing NMIBC.
8. patients with non-compliance to BCG doses or the scheduled follow up.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Maher Gamil Ahmed Higazy

principle investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ain Shams university

Cairo, , Egypt

Site Status

Countries

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Egypt

Other Identifiers

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MS 475/ 2021

Identifier Type: -

Identifier Source: org_study_id

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