Lymphocyte‐to‐monocyte ratio and neutrophil‐to‐lymphocyte ratio as biomarkers for predicting lymph node metastasis and survival in patients treated with radical cystectomy

D’Andrea, David; Moschini, Marco; Gust, Kilian M.; Abufaraj, Mohammad; Özsoy, Mehmet; Mathiéu, Romain; Soria, Francesco; Briganti, Alberto; Rouprêt, Morgan; Karakiewicz, Pierre I.; Shariat, Shahrokh F.

doi:10.1002/jso.24521

Cited by 45 publications

(48 citation statements)

References 36 publications

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“…A summary of 24 recent studies investigating the prognostic role of NLR in RCC according to treatment type is shown in Tables 8–11 . Table summarizes studies investigating the prognostic role of preoperative NLR in patients who underwent transurethral resection for NMIBC.…”

Section: Differential Blood Cell Markersmentioning

confidence: 99%

Role of systemic inflammatory response markers in urological malignancy

Ohno

2018

Int J of Urology

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The systemic inflammatory response is associated with survival in patients with a variety of cancers. This inflammatory response is measured in the peripheral blood, and can be monitored using two categories of indices: concentration of specific serum proteins (albumin, C‐reactive protein) and differential blood cell count (neutrophils, lymphocytes and platelets). Furthermore, combinations of these indices, such as the Glasgow Prognostic Score, which consists of the serum C‐reactive protein and albumin level; the neutrophil‐to‐lymphocyte ratio; the platelet‐to‐lymphocyte ratio; and the prognostic nutritional index, which is based on peripheral blood lymphocyte count and serum albumin level, have also been evaluated and compared in cancer research. To date, there are hundreds of studies that have shown the prognostic value of systemic inflammatory response markers in patients with urological cancer. Most studies have evaluated the prognostic and predictive role of the pretreatment value of the markers, although some have focused on the role of the post‐treatment value at specific points during the clinical course. The advantages of systemic inflammatory response markers are that they are easily measurable and inexpensive in the clinical setting. However, it is important to consider how clinicians use these markers in clinical practice. The present review provides a concise overview regarding systemic inflammatory markers in urological cancers, specifically C‐reactive protein, Glasgow Prognostic Score/modified Glasgow Prognostic Score, neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio and prognostic nutritional index.

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Section: Differential Blood Cell Markersmentioning

confidence: 99%

Role of systemic inflammatory response markers in urological malignancy

Ohno

2018

Int J of Urology

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“…In recent years, a number of studies have been looking for factors that can truly reflect the systemic inflammatory response in patients and exploring their value in risk stratification in tumor patients, such as C-reactive protein, the NLR, the PLR and the scoring system (GPS score) formed by combining multiple inflammatory factors [14,15]. Studies showed that the NLR was increased in patients undergoing RC with advanced or invasive diseases, manifested by increased tumor staging and lymph node metastasis [16,17]. In addition, preoperative increases in the NLR in patients with RC were associated with a poor prognosis [18,19].…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer

et al. 2020

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Background:A routine blood examination is one of the most rapid, convenient and inexpensive clinical examinations that can reflect a patient's inflammatory status and other blood conditions, and the prognostic value of routine preoperative blood parameters in MIBC patients is still unclear, so we evaluated the prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer (MIBC) following radical cystectomy (RC).Methods: Data on 202 patients with MIBC who underwent RC at our institution were retrospectively collected between October 2007 and August 2018. The median preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and hemoglobin (HGB) values were used as cutoffs to form the low and high NLR, low and high PLR, and low and high HGB groups, respectively. The clinicopathologic characteristics of each group were compared by chi-square and t tests. Kaplan-Meier survival and multivariate Cox regression analyses were used to analyze prognosis.Results: The median NLR, PLR and HGB values were 2.42, 112 and 125 g/L, respectively. Kaplan-Meier results showed that the low HGB group had poor progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). A high NLR and high PLR groups correlated only with poor OS. Multivariate Cox analyses showed that pathological T3/4 stage, positive lymph node status and low HGB were independent risk factors for PFS, CSS and OS, and age was the only independent risk factor for OS. Conclusion: Preoperative peripheral blood HGB is an independent risk factor for the prognosis of MIBC patients. These data suggest that HGB may be a useful prognostic marker for MIBC patients undergoing RC.

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“…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).…”

Section: Literature Search and Study Selectionmentioning

confidence: 99%

“…High NLR tends to be negatively correlated with poor survival in urothelial carcinoma (5). Some studies have suggested a link between high NLR with the pathologic stage of urothelial carcinoma, including muscle invasiveness (6,7), extravesical extension (8)(9)(10), and lymph-node positivity (10,11). Moreover, recent research has indicated that NLR is a predictive biomarker of treatment response (12).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, recent research has indicated that NLR is a predictive biomarker of treatment response (12). However, one large-scale study did not find a correlation between high preoperative NLRs and extra-vesical extension (11). Thus, the clinical utility of preoperative NLR as a prognostic or predictive biomarker in urothelial carcinoma is still controversial.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Purpose: We performed a study-level meta-analysis to summarize the current evidence on the correlation between pretreatment neutrophil-to-lymphocyte ratios (NLR) and oncological outcomes in each type of management for urothelial carcinoma. Method: All articles published until February 2017 in PubMed, Scopus, and EMBASE database were collected and reviewed. The current evidence on correlations between pretreatment NLR and oncological outcomes in each type of management for urothelial carcinoma, including transurethral resection of bladder tumor (TURBT), radical cystectomy (RCx), chemotherapy (CTx), and nephroureterectomy (NUx), were summarized. Results: Thirty-eight studies containing clinical information on 16,379 patients were analyzed in this study. Pooled hazard ratios (HR) and odds ratios (OR) with 95% confidence intervals were calculated after weighing each study. Heterogeneity among the studies and publication bias were assessed. Pretreatment NLR was significantly associated with muscle invasiveness (OR: 4.27), recurrence free survival (RFS, HR: 2.32), and progression-free survival (PFS, HR: 2.45) in TURBT patients. In the RCx patients, high NLR was negatively associated with both disease status (extravesical extension and lymph-node positivity, OR: 1.14 and 1.43, respectively) and oncological outcomes [overall survival (OS), PFS], and cancer specific survival (CSS, HR: 1.18, 1.12, and 1.35, respectively). Pretreatment NLR was negatively correlated with pathologic downstaging (OR: 0.79) and positively correlated with PFS (HR: 1.30) and OS (HR: 1.44) in CTx patients. For patients who underwent NUx, pretreatment NLR was significantly associated with OS (HR: 1.72), PFS (HR: 1.63), and CSS (HR: 1.68). Conclusions: Pretreatment NLR is a useful biomarker for disease aggressiveness, oncological outcome, and treatment response in the management of patients with urothelial carcinoma. More evidence is needed to clarify these results.

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Lymphocyte‐to‐monocyte ratio and neutrophil‐to‐lymphocyte ratio as biomarkers for predicting lymph node metastasis and survival in patients treated with radical cystectomy

Cited by 45 publications

References 36 publications

Role of systemic inflammatory response markers in urological malignancy

Role of systemic inflammatory response markers in urological malignancy

The prognostic value of routine preoperative blood parameters in muscle-invasive bladder cancer

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

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