Low Pretreatment Neutrophil-to-Lymphocyte Ratio Predicts for Good Outcomes in Patients Receiving Neoadjuvant Chemotherapy Before Radical Cystectomy for Muscle Invasive Bladder Cancer

Combined assessment of peritumoral Th1/Th2 polarization and peripheral immunity as a new biomarker in the prediction of BCG response in patients with high-risk NMIBC

“…In addition to local immunity, the peripheral absolute lymphocyte count has been associated with an inferior outcome in various cancers. 19 Furthermore, peripheral NLR has been postulated to be a prognostic factor for individuals with MIBC [26][27][28] and higher values of NLR have been associated with an increased risk of disease recurrence and overall survival in NMIBC. 29,30 In the present study and consistent with a recently published report, 39 a higher NLR prior to BCG treatment value was identified in BCG nonresponders, although the difference did not reach significance.…”

“…20 Furthermore, the neutrophil-to-lymphocyte ratio (NLR), a measure of systemic inflammation and a strong predictor for prognosis in patients with different diseases, 21,22 has been suggested to be a prognostic predictor for overall survival and disease free survival and a predictive marker of the response to treatment in many cancers. 23 In bladder cancer, high NLR has been associated with poor clinical outcome in individuals with muscle-invasive bladder cancer (MIBC), 24,25 it has been postulated as a prognostic factor for individuals with MIBC undergoing neoadjuvant chemotherapy [26][27][28] and it correlates with disease progression and recurrence in individuals with NMIBC. 29,30 Overall, immune biomarkers based on TILs or blood cells have been independently described in cancer patients; however, the possibility that a combination of both factors could generate a more reliable prognostic biomarker has not previously been explored.…”

Clinical Significance of Pre-treated Neutrophil-Lymphocyte Ratio in the Management of Urothelial Carcinoma: A Systemic Review and Meta-Analysis

“…Full-text reviews were performed by the two investigators. Finally, 38 studies were selected for meta-analysis ( Figure 2), including seven articles on TURBT (6,7,(15)(16)(17)(18)(19), 15 on radical cystectomy (8)(9)(10)(11)(12)(20)(21)(22)(23)(24)(25)(26)(27)(28), five on chemotherapy (29)(30)(31)(32)(33), and 11 on nephroureterectomy for upper ureter urothelial carcinoma (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44).…”

“…Regarding the parameters of oncological outcomes, cancer-specific survival (CSS), overall survival, and progression-free survival (PRS) had sufficient data for linkage analysis with preoperative NLRs. Most studies set cutoff values for NLR from 2.3 to 5, however, three studies used it as a continuous variable (12,23,25). The studies were conducted in many countries.…”

“…Heterogeneity between the two studies was highly present (I 2 = 97%, p < 0.00001) ( Figure 4B). Pathologic downstaging after neoadjuvant chemotherapy was evaluated in two studies (20,25). The pooled OR was calculated to be 0.79 (95% CI: 0.64-0.99).…”