The Prognostic Significance of the Early Postoperative Neutrophil-to-Lymphocyte Ratio in Patients with Urothelial Carcinoma of the Bladder Undergoing Radical Cystectomy

Kang, Minyong; Jeong, Chang Wook; Kwak, Cheol; Kim, Hyeon Hoe; Ku, Ja Hyeon

doi:10.1245/s10434-015-4708-8

Cited by 58 publications

(49 citation statements)

References 29 publications

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“…They also stated that NLR is associated with extravesical disease. [31] In our study, a preoperative cut-off value of NLR was found as 4.05 with a 45% sensitivity, 88% specificity in patients with organ-confined cancer as detected histopathologically in TURBT specimens. Our results showed higher number of positive LNs and a higher rate of positive LNs in this group of patients.…”

Section: Discussionsupporting

confidence: 46%

“…With a similar cut-off value, Krane et al [30] reported that the patients with elevated NLR before RC have worse overall survival than patients without markers of systemic inflammation. In another study, Kang et al [31] revealed that postoperative NLR during the early recovery period demonstrated prognostic significance for bladder cancer patients undergoing RC with pelvic lymph node dissection with a NLR cut-off value of 2. They also stated that NLR is associated with extravesical disease.…”

Section: Discussionmentioning

confidence: 99%

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Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

Şefik

Günlüsoy

Aydoğdu

et al. 2018

Turkish Journal of Urology

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Objective: The aim of this study is to examine the usefulness of preoperative neutrophile-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratios to predict pathological upstaging of invasive bladder cancer who underwent radical cystectomy. Material and methods:A total of 126 patients who underwent radical cystectomy at our clinic between January 2006 and March 2015 were retrospectively analysed. One hundred and twelve patients with organconfined invasive bladder tumors (T2) detected at histopathological examination of transuretral resection material were included in the study. Upstaging was seen at histopathological examination of radical cystectomy specimens of 42 patients. We compared preoperative neutrophile-to-lymphocyte ratio, platelet-tolymphocyte ratio, lymphocyte-to-monocyte ratio between upstaged and not-upstaged groups.Results: There were no statistically significant correlation between age, time to radical cystectomy, gender, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio ratios and carcinoma in situ in upstaged and non-upstaged groups. Statistical analyses showed that preoperative neutrophile-to-lymphocyte ratio was higher in upstaged patients (p= 0.009). In multivariate analysis preoperative neutrophile-to-lymphocyte ratio and positive surgical margin were significantly higher in upstaged group. Conclusion:In organ-confined muscle invasive bladder cancer neutrophile-to-lymphocyte ratio seems to be an acceptable parameter to predict locally advanced disease.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

Şefik

Günlüsoy

Aydoğdu

et al. 2018

Turkish Journal of Urology

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“…Therefore, 139 remaining studies were further evaluated for eligibility, and 118 studies were further excluded because they were animal studies, had no survival data with the pretreatment NLR, were without sufficient data to extract the HRs and 95% confidence intervals (CIs), used a continuous variable as the cut-off value, or had overlapping patients or < 10 patients. A total of 21 studies were finally included in this pooled analysis, of which 17 studies included 11, 262 bladder cancer patients treated with RC or TURBT [15-17, 28-41] and 4 studies involved 862 mUC or uUC patients treated with systemic chemotherapy [42-45]. The flow diagram for the study selection process is depicted in Fig.…”

Section: Resultsmentioning

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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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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“…Although numerous studies have demonstrated associations between preoperative NLR and outcomes in primary operable patients with NSCLC,5–8 other studies have concluded the opposite 9,10. Moreover, some studies found that postoperative NLR could predict the survival of patients with hepatocellular carcinoma,11 colorectal cancer,12 and bladder cancer after complete resection 13. These results suggest that postoperative NLR might provide a more precise reflection of the balance between tumor inflammatory response and host immune response.…”

Section: Introductionmentioning

confidence: 99%

The postoperative neutrophil-to-lymphocyte ratio and changes in this ratio predict survival after the complete resection of stage I non-small cell lung cancer

Jin¹,

Han

Shi

et al. 2016

OTT

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PurposeAlthough numerous studies have demonstrated associations between the preoperative neutrophil-to-lymphocyte ratio (NLR) and long-term outcomes in patients with non-small cell lung cancer (NSCLC), the prognostic significance of postoperative NLR and change in NLR (ΔNLR) is unknown for patients who underwent complete resection of stage I NSCLC. The aim of this retrospective study was to evaluate the prognostic significance of postoperative NLR and ΔNLR in 123 patients with stage I NSCLC.Patients and methodsThis retrospective study included preoperative and postoperative data of 123 patients who underwent surgical resection for stage I NSCLC. The relationship between disease-free survival (DFS), overall survival (OS), and clinicopathological factors, including NLR, lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio, and their changes, was analyzed using both univariate Kaplan–Meier and multivariate Cox regression methods.ResultsThe 5-year DFS and OS rates in our cohort were 60.16% and 67.48%, respectively. Univariate analysis revealed that age (P=0.045), smoking status (P=0.033), preoperative NLR (P=0.032), postoperative NLR (P<0.001), ΔNLR (P=0.004), and change in LMR (ΔLMR) (P=0.025) were significant predictors of DFS and that age (P=0.039), smoking status (P=0.042), postoperative NLR (P<0.001), ΔNLR (P=0.004), and ΔLMR (P=0.011) were independent predictors of OS. Multivariate analysis confirmed that postoperative NLR (hazard ratio [HR] =2.435, P=0.001) and ΔNLR (HR =2.103, P=0.012) were independent predictors of DFS and that postoperative NLR (HR =2.747, P=0.001) and ΔNLR (HR =2.052, P=0.018) were significant prognostic factors of OS.ConclusionOur study reported for the first time that postoperative NLR and ΔNLR – but not preoperative NLR – were independent prognostic factors of DFS and OS in patients with stage I NSCLC who underwent complete resection. This easily available biomarker might be helpful in individual risk assessment.

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The Prognostic Significance of the Early Postoperative Neutrophil-to-Lymphocyte Ratio in Patients with Urothelial Carcinoma of the Bladder Undergoing Radical Cystectomy

Abstract: In summary, postoperative NLR in the early recovery period can be a valuable biomarker for predicting oncologic outcomes for bladder cancer patients undergoing RC.

Cited by 58 publications

References 29 publications

Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

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

The postoperative neutrophil-to-lymphocyte ratio and changes in this ratio predict survival after the complete resection of stage I non-small cell lung cancer

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