Association of Inflammatory and Nutritional Biomarkers with Pathological Response in Patients with Muscle-invasive Bladder Carcinoma Treated with Neoadjuvant Chemotherapy

Background: Bladder cancer is a prevalent urological malignancy, highlighting the need for prognostic biomarkers to optimise and individualise treatment strategies. This study aimed to assess the prognostic value of preoperative inflammatory and nutritional markers in patients with non-metastatic muscle-invasive bladder cancer (MIBC) treated with neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC), focusing on pathological response and survival. Methods: This retrospective observational study included 133 patients with non-metastatic MIBC treated with NAC and RC between July 2011 and December 2024. Preoperative inflammatory and nutritional indices, including neutrophil/lymphocyte ratio (NLR), total lymphocyte count (TLC), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), systemic immune inflammation index (SII) and nutritional prognostic index (NPI), were analysed and correlated with pathological response (complete, partial, or no response/progression). Results: Hematologic indices were associated with pathological response. Specifically, TLC (p