Prognostic value of neutrophil-to-lymphocyte ratio in urothelial carcinoma of the upper urinary tract and bladder: a systematic review and meta-analysis

Li, Xintao; Ma, Xin; Tang, Lu; Wang, Qianqian; Chen, Luyao; Zhang, Fan; Zhang, Xu

doi:10.18632/oncotarget.17467

Cited by 42 publications

(33 citation statements)

References 65 publications

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“…Therefore, we assessed the association between the pretreatment NLR and pathological characteristics, and our pooled results demonstrated that the pretreatment NLR could be a significant indicator for lymphovascular invasion (yes vs. no), margin status (positive vs. negative), tumor stage (≥T3 vs. <T3 or T1 vs. Ta) and tumor grade (3 vs. 1, 2). However, no significant association could be found between the pretreatment NLR and concomitant Cis, lymph node involvement, lymph node stage, tumor multifocality or tumor size, which were similar to the pooled results in urothelial carcinoma but differed to some extent [21]. …”

Section: Discussionmentioning

confidence: 52%

“…Previous systematic reviews and meta-analyses have assessed the NLR as a prognostic indicator in upper urinary tract urothelial carcinoma (UUTUC) [20] or urothelial carcinomas [21]. Although UUTUC and urothelial carcinoma of the bladder share many features, they represent two different diseases with varying risk factors, biological behaviors and prognoses [4, 22].…”

Section: Introductionmentioning

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: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

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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“…The influence of NLR on patients’ survival time was investigated in some studies [10, 27-30]. The results of a study conducted by Wei et al [10] showed that NLR could be a significant prognostic biomarker in urinary cancers.…”

Section: Discussionmentioning

confidence: 99%

“…In subgroup analyses, high NLR was associated with a worse OS in RCC (HR 1.9, 95% CI 1.47–2.45) and a poor RFS/CSS in RCC (HR 1.83, 95% CI 1.35–2.48), bladder cancer (HR 2.2, 95% CI 1.27–3.8), and urothelial carcinoma (HR 2.58, 95% CI 1.66–4.01) [10]. In another study, increased pretreatment NLR predicted poor OS (HR 1.72, 95% CI 1.45–2.05), PFS (HR 1.68, 95% CI 1.44–1.96), and CSS (HR 1.64, 95% CI 1.39–1.93) in all patients with urothelial carcinoma of the upper urinary tract and bladder [27]. In a group of patients treated at Memorial Sloan Kettering Cancer Center with partial or radical nephrectomy for nonmetastatic clear cell renal carcinoma elevated NLR was significantly associated with worse RFS, CSS, and OS ( p < 0.0001) in univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

The Role of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, and Platelets in the Prognosis of Metastatic Renal Cell Carcinoma

et al. 2019

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Objective(s): The aim of this analysis was to evaluate the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), platelets (PLT), and neutrophil level for their prognostic value in patients with metastatic renal cell carcinoma (mRCC). Materials: We retrospectively reviewed medical records of 141 patients with mRCC (2006–2016). Univariate and multivariate analyses were performed with the Cox proportional hazards regression model. The cutoff value of NLR was “elevated” as >3.68 and the PLR cutoff value was “elevated” as >144.4. Results: The median PFS and OS were shorter in elevated NLR and PLR. A higher value of PLT was associated with worse median OS and higher neutrophil level with worse OS and PFS. In multivariate analysis, higher NLR (p = 0.007) and PLR (p = 0.006) were independent prognostic factors for shorter OS together with BMI ≤30 (p = 0.004), higher Fuhrman grade (p = 0.0002), lower level of hemoglobin (p= 0.010), and ZUBROD 2 (p = 0.0002). Higher PLR (p = 0.0002) was an independent negative prognostic factor for PFS together with higher Fuhrman grade (p = 0.001), higher neutrophil level (p = 0.001), and lower lymphocyte level (p = 0.013). Conclusion: Elevated pretreatment NLR, PLR, PLT, and neutrophil count are associated with shorter OS and PFS in patients with mRCC. NLR and PLR are independent prognostic factors for OS. However, PLR and neutrophil count are independent prognostic factors for PFS.

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“…To date, there have been a large number of studies regarding the prognostic value of NLR in urological cancer, including RCC, UC and PC . In addition, several meta‐analyses showed that increased NLR is associated with worse outcome …”

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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Prognostic value of neutrophil-to-lymphocyte ratio in urothelial carcinoma of the upper urinary tract and bladder: a systematic review and meta-analysis

Cited by 42 publications

References 65 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

The Role of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, and Platelets in the Prognosis of Metastatic Renal Cell Carcinoma

Role of systemic inflammatory response markers in urological malignancy

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