High Neutrophil-to-lymphocyte Ratio Persistent During First-line Chemotherapy Predicts Poor Clinical Outcome in Patients with Advanced Urothelial Cancer

Rossi, Lorena; Santoni, Matteo; Crabb, Simon J.; Scarpi, Emanuela; Burattini, Luciano; Chau, Caroline; Bianchi, Emanuela; Savini, Agnese; Burgio, Salvatore Luca; Conti, Alessandro; Conteduca, Vincenza; Cascinu, Stefano; Giorgi, Ugo De

doi:10.1245/s10434-014-4097-4

Cited by 85 publications

(90 citation statements)

References 32 publications

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“…The prognostic role of the pretreatment NLR regarding RFS, PFS and disease-specific survival/cancer-specific survival (DSS/CSS) in bladder cancer patients was evaluated in 9, 7 and 9 studies, respectively. Of the 21 included studies, Hermanns’s study reported adjusted HRs and 95% CIs [29], while 3 studies reported HRs and 95% CIs derived only from a univariate analysis [42, 44, 45]; the remaining studies presented HRs and 95% CIs obtained by a multivariate analysis. With regard to the quality assessment of the included studies, the Newcastle-Ottawa Scale (NOS) scores ranged from 6 to 8.…”

Section: Resultsmentioning

confidence: 99%

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Pretreatment Neutrophil-Lymphocyte Ratio as a Predictor in Bladder Cancer and Metastatic or Unresectable Urothelial Carcinoma Patients: a Pooled Analysis of Comparative Studies

Zhao

Wang

et al. 2018

Cell Physiol Biochem

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Background/Aims: Emerging studies have shown that the neutrophil-lymphocyte ratio (NLR) is a potential predictor in various tumors. Our study was conducted to assess the prognostic value of the pretreatment NLR in bladder cancer and metastatic or unresectable urothelial carcinoma (mUC or uUC) patients up to July 2017. The correlation between the pretreatment NLR and pathological characteristics was also evaluated in bladder cancer patients. Methods: The hazard ratio (HR) and odds ratio (OR) with the 95% confidence interval (CI) were extracted or calculated from the included studies for further pooled analysis. A total of 21 studies were included in a pooled analysis. Results: The pooled results indicated that a high pretreatment NLR was associated with reduced overall survival (OS) (HR=1.27, 95% CI=1.12-1.43), relapse-free survival (RFS) (HR=1.41, 95% CI=1.23-1.60), progression-free survival (PFS) (HR=1.75, 95% CI=1.36-2.15), disease-specific survival (DSS) and cancer-specific survival (CSS) (HR=1.27, 95% CI=1.19-1.35) in the bladder cancer patients. Additionally, an elevated pretreatment NLR suggested a worse OS rate in the mUC or uUC patients (HR=1.63, 95% CI=1.34-1.91). The pooled ORs and 95% CIs showed that a high pretreatment NLR could be a risk indicator for certain pathological features, such as lymphovascular invasion, a positive margin status and advanced tumor stage. Conclusions: our results showed that a high pretreatment NLR predicted poor prognosis in bladder cancer, mUC and uUC patients.

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Section: Resultsmentioning

confidence: 99%

“…Additionally, nearly all the included studies reported multivariate HRs and 95% CIs. However, three studies involving mUC or uUC patients reported only univariate HRs and 95% CIs [42, 44, 45], which may have overestimated the prognostic role of the pretreatment NLR.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment Neutrophil-Lymphocyte Ratio as a Predictor in Bladder Cancer and Metastatic or Unresectable Urothelial Carcinoma Patients: a Pooled Analysis of Comparative Studies

Zhao

Wang

et al. 2018

Cell Physiol Biochem

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“…Several studies have shown that platelets induce circulating tumor cell epithelial-mesenchymal transition and promote extravasation to metastatic sites [25, 26]. Neutrophils promote adhesion and seeding of distant organ sites through the secretion of circulating growth factors such as VEGF and proteases [27, 28]. Lymphocytes play a crucial role in tumor defense by inducing cytotoxic cell death and inhibiting tumor cell proliferation and migration, thereby dictating the host's immune response to malignancy [29].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer

et al. 2016

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BackgroundTo investigate the role of pre-treatment inflammatory indexes (II) as predictors of prognosis and treatment efficacy in patients with metastatic colorectal cancer mCRC randomized onto the prospective multicenter randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial to receive first-line chemotherapy (CT) with or without bevacizumab (Bev).ResultsIn the overall population, PFS and OS were higher in patients with low SII (p = .015 and .002, respectively), low NLR (p = .0001 and <.0001, respectively) and low PLR (p = .004 and .008, respectively). Patients with low NLR in the CT plus Bev arm had a higher PFS than those treated with CT alone (HR = 0.69, p = .021).Patients and MethodsTwo hundred and eighty-nine patients were considered for this study, 141 receiving CT plus Bev and 148 receiving CT alone. The pre-treatment systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were evaluated to identify a potential correlation with progression-free (PFS) and overall survival (OS) in both the overall population and the 2 treatment arms.ConclusionOur results indicate that II, in particular NLR, are good prognostic and predictive markers for mCRC patients who are candidates for CT plus Bev.

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“…In contrast, lymphocytes, particularly cytotoxic T cells, play a crucial role in the antitumour immune response by promoting apoptosis and suppressing tumour growth 14 . Accordingly, the neutrophil-lymphocyte ratio (nlr), a cost-effective and simple inf lammatory parameter, might correlate bot h w it h pat ient outcome a nd w it h response to chemo therapy 15 . An elevated nlr has been described to correlate with poor outcome in a variety of cancers, including breast cancer [16][17][18][19] .…”

Section: Introductionmentioning

confidence: 99%

Neutrophil–Lymphocyte Ratio Predicts Response to Chemotherapy in Triple-Negative Breast Cancer

et al. 2018

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High Neutrophil-to-lymphocyte Ratio Persistent During First-line Chemotherapy Predicts Poor Clinical Outcome in Patients with Advanced Urothelial Cancer

Abstract: An increased NLR persistent during first-line chemotherapy is an independent predictive factor for patients with advanced urothelial cancer.

Cited by 85 publications

References 32 publications

Pretreatment Neutrophil-Lymphocyte Ratio as a Predictor in Bladder Cancer and Metastatic or Unresectable Urothelial Carcinoma Patients: a Pooled Analysis of Comparative Studies

Pretreatment Neutrophil-Lymphocyte Ratio as a Predictor in Bladder Cancer and Metastatic or Unresectable Urothelial Carcinoma Patients: a Pooled Analysis of Comparative Studies

Inflammatory indexes as predictors of prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer

Neutrophil–Lymphocyte Ratio Predicts Response to Chemotherapy in Triple-Negative Breast Cancer

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