Background: Urothelial carcinoma of the bladder (UCB) demonstrates considerable heterogeneity, with markedly varying outcomes between non–muscle-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 × platelets × monocytes) ÷ lymphocytes. Additional indices included the NLR, SII, SIRI, and PLR. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan–Meier 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 < 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.

Objective: The aim of this study was to evaluate and compare the perioperative, oncological and long-term renal functional outcomes of the zero ischemia (off-clamp) and standard warm ischemia (on-clamp) approaches in patients undergoing robotic partial nephrectomy (RPN).Materials and Methods: This retrospective cohort study examined 56 consecutive patients who underwent RPN for renal masses. The patients were divided into two groups: a zero ischemia group (n = 26) and a warm ischemia group (n = 30). Preoperative demographics, tumour characteristics (RENAL, PADUA and C-index) and perioperative data were recorded. Renal function was assessed using serum creatinine levels and estimated glomerular filtration rates (eGFR) before surgery, on the first day after surgery, and after one year.Results: There were no differences in demographic variables or tumour complexity scores (RENAL, PADUA) between the groups. The C-index score was significantly higher in the zero ischemia group (median 3.1 vs. 1.86, p = 0.001), indicating a more peripheral tumour location. Although postoperative complication (p = 0.494) and positive surgical margin (PSM) (p = 0.140) rates were comparable, estimated blood loss (300 ml vs. 100 ml, p < 0.001) and hospital stay (4 days vs. 3 days, p = 0.001) were higher in the zero ischemia cohort. Both groups experienced an initial deterioration in renal function, but the zero ischemia group’s eGFR and creatinine levels recovered to baseline within one year (p = 0.970). In contrast, the warm ischemia group experienced a significant decline in eGFR that persisted at one year (p = 0.001).Conclusion: The zero ischemia approach in RPN may offer functional advantages, particularly in selected patients, in terms of complete long-term preservation of renal function compared to standard warm ischemia. Despite slightly increased intraoperative bleeding, this approach demonstrates comparable PSM rates, particularly for anatomically suitable, peripherally located tumours.