Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer
Objective: To determine the role of neutrophil-to-lymphocyte ratio (NLR) in prognosticating survival outcomes in patients with advanced/metastatic urothelial bladder cancer. Methods: We retrospectively reviewed 84 patients undergoing radical cystectomy (RC) for UCB from January 2002 to June 2012. NL...
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Elsevier
2017-10-01
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| Series: | Asian Journal of Urology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388217300267 |
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| author | Yu Guang Tan Ernest Eu Weber Lau Kam On Hong Hong Huang |
| author_facet | Yu Guang Tan Ernest Eu Weber Lau Kam On Hong Hong Huang |
| author_sort | Yu Guang Tan |
| collection | DOAJ |
| description | Objective: To determine the role of neutrophil-to-lymphocyte ratio (NLR) in prognosticating survival outcomes in patients with advanced/metastatic urothelial bladder cancer.
Methods: We retrospectively reviewed 84 patients undergoing radical cystectomy (RC) for UCB from January 2002 to June 2012. NLR was computed (median: 5 days) prior to surgery. No patients received neoadjuvant chemotherapy. NLR was analyzed as a continuous variable and a cut-off point of 2.7 was obtained, with a statistical receiver operating characteristics of 0.74. Kaplan–Meier curves, multivariate Cox proportional hazard and logistics regression models were used to predict NLR association with survival outcomes.
Results: The median follow-up period was 30.1 months (range: 3.2–161.7) owing to high recurrence rate and subsequent mortalities, compared to the median 64.7 months in patients alive at the end of study period. NLR ≥2.7 was associated with worse survival outcomes (5-year disease-specific survival: 22% vs 58%, p = 0.017, 95%CI: 1.193–6.009; 5-year overall survival: 23% vs 60%, p = 0.008, 95%CI: 1.322–6.147). Furthermore, on multivariate analyses, higher NLR was independently associated with higher recurrence rate (p = 0.007, HR =6.999, 95%CI: 1.712–28.606), higher T staging (p = 0.021, HR = 3.479, 95%CI: 1.212–9.990) and lymph node involvement (p = 0.009, HR = 4.534, 95%CI: 1.465–14.034).
Conclusion: This study suggests that NLR can be an inexpensive novel factor for patients risk stratification pre-operatively. This improves patient counseling and identifies patients who may benefit from multimodal treatment. |
| format | Article |
| id | doaj-art-c0e37abc96c14ebb96a9976fd50dbe96 |
| institution | OA Journals |
| issn | 2214-3882 |
| language | English |
| publishDate | 2017-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-c0e37abc96c14ebb96a9976fd50dbe962025-08-20T02:15:33ZengElsevierAsian Journal of Urology2214-38822017-10-014423924610.1016/j.ajur.2017.01.004Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancerYu Guang TanErnest EuWeber Lau Kam OnHong Hong HuangObjective: To determine the role of neutrophil-to-lymphocyte ratio (NLR) in prognosticating survival outcomes in patients with advanced/metastatic urothelial bladder cancer. Methods: We retrospectively reviewed 84 patients undergoing radical cystectomy (RC) for UCB from January 2002 to June 2012. NLR was computed (median: 5 days) prior to surgery. No patients received neoadjuvant chemotherapy. NLR was analyzed as a continuous variable and a cut-off point of 2.7 was obtained, with a statistical receiver operating characteristics of 0.74. Kaplan–Meier curves, multivariate Cox proportional hazard and logistics regression models were used to predict NLR association with survival outcomes. Results: The median follow-up period was 30.1 months (range: 3.2–161.7) owing to high recurrence rate and subsequent mortalities, compared to the median 64.7 months in patients alive at the end of study period. NLR ≥2.7 was associated with worse survival outcomes (5-year disease-specific survival: 22% vs 58%, p = 0.017, 95%CI: 1.193–6.009; 5-year overall survival: 23% vs 60%, p = 0.008, 95%CI: 1.322–6.147). Furthermore, on multivariate analyses, higher NLR was independently associated with higher recurrence rate (p = 0.007, HR =6.999, 95%CI: 1.712–28.606), higher T staging (p = 0.021, HR = 3.479, 95%CI: 1.212–9.990) and lymph node involvement (p = 0.009, HR = 4.534, 95%CI: 1.465–14.034). Conclusion: This study suggests that NLR can be an inexpensive novel factor for patients risk stratification pre-operatively. This improves patient counseling and identifies patients who may benefit from multimodal treatment.http://www.sciencedirect.com/science/article/pii/S2214388217300267Bladder cancerNeutrophil-to-lymphocyte ratioRadical cystectomyBladder carcinoma |
| spellingShingle | Yu Guang Tan Ernest Eu Weber Lau Kam On Hong Hong Huang Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer Asian Journal of Urology Bladder cancer Neutrophil-to-lymphocyte ratio Radical cystectomy Bladder carcinoma |
| title | Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer |
| title_full | Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer |
| title_fullStr | Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer |
| title_full_unstemmed | Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer |
| title_short | Pretreatment neutrophil-to-lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer |
| title_sort | pretreatment neutrophil to lymphocyte ratio predicts worse survival outcomes and advanced tumor staging in patients undergoing radical cystectomy for bladder cancer |
| topic | Bladder cancer Neutrophil-to-lymphocyte ratio Radical cystectomy Bladder carcinoma |
| url | http://www.sciencedirect.com/science/article/pii/S2214388217300267 |
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