Top

International Journal of Clinical Oncology

Published in:

01-10-2017 | Original Article

A critical prognostic analysis of neutrophil–lymphocyte ratio for patients undergoing nephroureterectomy due to upper urinary tract urothelial carcinoma

Authors: Mesut Altan, Hakan Bahadır Haberal, Bülent Akdoğan, Haluk Özen

Published in: International Journal of Clinical Oncology | Issue 5/2017

Abstract

Background

To determine preoperative serum complete blood count parameters that affects survival of patients who underwent surgery for upper urinary tract urothelial cancer (UUT-UC).

Methods

Since 1990, 150 patients underwent nephroureterectomy with bladder cuff excision for UUT-UC at Hacettepe University. Patients with a history of muscle-invasive bladder cancer, adjuvant chemotherapy or metastasis at the time of diagnosis were excluded. One hundred and thirteen patients without infective symptoms and with a full set of serum data were evaluated retrospectively. Effects of the neutrophil–lymphocyte ratio (NLR), lymphocyte–monocyte ratio (LMR), platelet–lymphocyte ratio (PLR), and leukocyte count on disease-free survival (DFS) and progression-free survival (PFS) were investigated. Threshold values for each parameter to predict PFS were calculated.

Results

The mean age and median follow-up were 63.7 ± 11.1 years and 34 (3–186) months, respectively. Male to female ratio was 86/27. The 5-years PFS (bladder recurrence was excluded) and DFS were 59.6 and 38.4%, respectively. In multivariate analysis, NLR was independent prognostic factor for PFS and DFS (p = 0.006 and p = 0.021, respectively) while LMR was prognostic only for PFS (p = 0.037).

Conclusion

For UUT-UC, NLR is a prognostic factor for PFS and DFS, while LMR is a prognostic indicator for PFS in present series.

Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62(1):10–29CrossRefPubMed

David KA, Mallin K, Milowsky MI et al (2009) Surveillance of urothelial carcinoma: stage and grade migration, 1993–2005 and survival trends, 1993–2000. Cancer 115(7):1435–1447CrossRefPubMed

Margulis V, Shariat SF, Matin SF et al (2009) Outcomes of radical nephroureterectomy: a series from the upper tract urothelial carcinoma collaboration. Cancer 115(6):1224–1233CrossRefPubMed

Fajkovic H, Cha EK, Xylinas E et al (2013) Disease-free survival as a surrogate for overall survival in upper tract urothelial carcinoma. World J Urol 31(1):5–11CrossRefPubMed

Kobayashi K, Saito T, Kitamura Y et al (2016) Effect of preoperative chemotherapy on survival of patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes. Int J Urol 23(2):153–158CrossRefPubMed

Porten S, Siefker-Radtke AO, Xiao L et al (2014) Neoadjuvant chemotherapy improves survival of patients with upper tract urothelial carcinoma. Cancer 120(12):1794–1799CrossRefPubMedPubMedCentral

Lughezzani G, Burger M, Margulis V et al (2012) Prognostic factors in upper urinary tract urothelial carcinomas: a comprehensive review of the current literature. Eur Urol 62(1):100–114CrossRefPubMed

Margulis V, Youssef RF, Karakiewicz PI et al (2010) Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract. J Urol 184(2):453–458CrossRefPubMed

Mantovani A, Allavena P, Sica A et al (2008) Cancer-related inflammation. Nature 454(7203):436–444CrossRefPubMed

10.

Deng Y, Pang Q, Miao RC et al (2016) Prognostic significance of pretreatment albumin/globulin ratio in patients with hepatocellular carcinoma. Onco Targets Ther 9:5317–5328CrossRefPubMedPubMedCentral

11.

Sung HH, Jeon HG, Jeong BC et al (2015) Clinical significance of prognosis using the neutrophil-lymphocyte ratio and erythrocyte sedimentation rate in patients undergoing radical nephroureterectomy for upper urinary tract urothelial carcinoma. BJU Int 115(4):587–594CrossRefPubMed

12.

Azuma T, Matayoshi Y, Odani K et al (2013) Preoperative neutrophil-lymphocyte ratio as an independent prognostic marker for patients with upper urinary tract urothelial carcinoma. Clin Genitourin Cancer 11(3):337–341CrossRefPubMed

13.

Dalpiaz O, Ehrlich GC, Mannweiler S et al (2014) Validation of pretreatment neutrophil–lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma. BJU Int 114(3):334–339PubMed

14.

Cappellini MD, Motta I (2015) Anemia in clinical practice-definition and classification: does hemoglobin change with aging? Semin Hematol 52(4):261–269CrossRefPubMed

15.

Hanahan D, Weinberg RA (2000) The hallmarks of cancer. Cell 100(1):57–70CrossRefPubMed

16.

Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144(5):646–674CrossRefPubMed

17.

Gabrilovich DI, Nagaraj S (2009) Myeloid-derived suppressor cells as regulators of the immune system. Nat Rev Immunol 9(3):162–174CrossRefPubMedPubMedCentral

18.

Kusumanto YH, Dam WA, Hospers GA et al (2003) Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis 6(4):283–287CrossRefPubMed

19.

Azab B, Bhatt VR, Phookan J et al (2012) Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol 19(1):217–224CrossRefPubMed

20.

Ding PR, An X, Zhang RX et al (2010) Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer. Int J Colorectal Dis 25(12):1427–1433CrossRefPubMed

21.

Pages F, Berger A, Camus M et al (2005) Effector memory T cells, early metastasis, and survival in colorectal cancer. N Engl J Med 353(25):2654–2666CrossRefPubMed

22.

Fujita K, Uemura M, Yamamoto Y et al (2015) Preoperative risk stratification for cancer-specific survival of patients with upper urinary tract urothelial carcinoma treated by nephroureterectomy. Int J Clin Oncol 20(1):156–163CrossRefPubMed

23.

McMillan DC (2013) The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev 39(5):534–540CrossRefPubMed

24.

Tanaka N, Kikuchi E, Kanao K et al (2014) A multi-institutional validation of the prognostic value of the neutrophil-to-lymphocyte ratio for upper tract urothelial carcinoma treated with radical nephroureterectomy. Ann Surg Oncol 21(12):4041–4048CrossRefPubMed

25.

Cheng YC, Huang CN, Wu WJ et al (2016) The prognostic significance of inflammation-associated blood cell markers in patients with upper tract urothelial carcinoma. Ann Surg Oncol 23(1):343–351CrossRefPubMed

26.

Sparr KE, Balcom AH, Mesrobian HG (1998) Incidence and natural history of contralateral vesicoureteral reflux in patients presenting with unilateral disease. J Urol 160(3 Pt 2):1023–1025CrossRefPubMed

27.

Chen Q, Dai Z, Yin D et al (2015) Negative impact of preoperative platelet-lymphocyte ratio on outcome after hepatic resection for intrahepatic cholangiocarcinoma. Medicine 94(13):e574CrossRefPubMedPubMedCentral

28.

Hutterer GC, Stoeckigt C, Stojakovic T et al (2014) Low preoperative lymphocyte-monocyte ratio (LMR) represents a potentially poor prognostic factor in nonmetastatic clear cell renal cell carcinoma. Urol Oncol 32(7):1041–1048CrossRefPubMed

29.

Song X, Zhang GM, Ma XC et al (2016) Comparison of preoperative neutrophil-lymphocyte, lymphocyte-monocyte, and platelet-lymphocyte ratios in patients with upper urinary tract urothelial carcinoma undergoing radical nephroureterectomy. Onco Targets Ther 9:1399–1407CrossRefPubMedPubMedCentral

30.

Kaag M, Trost L, Thompson RH et al (2014) Preoperative predictors of renal function decline after radical nephroureterectomy for upper tract urothelial carcinoma. BJU Int 114(5):674–679CrossRefPubMed

31.

Xylinas E, Rink M, Margulis V et al (2013) Impact of renal function on eligibility for chemotherapy and survival in patients who have undergone radical nephro-ureterectomy. BJU Int 112(4):453–461CrossRefPubMed

Title: A critical prognostic analysis of neutrophil–lymphocyte ratio for patients undergoing nephroureterectomy due to upper urinary tract urothelial carcinoma
Authors: Mesut Altan
Hakan Bahadır Haberal
Bülent Akdoğan
Haluk Özen
Publication date: 01-10-2017
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 5/2017
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-017-1150-x

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2017

The clinical use of neutrophil-to-lymphocyte ratio in bladder cancer patients: a systematic review and meta-analysis

The survival and prognosticators of peritoneal cytology-positive gastric cancer patients who received upfront gastrectomy and subsequent S-1 chemotherapy

Risk factors for paraaortic lymph node metastasis in endometrial cancer

Dasatinib rapidly induces deep molecular response in chronic-phase chronic myeloid leukemia patients who achieved major molecular response with detectable levels of BCR-ABL1 transcripts by imatinib therapy

Predictors for recurrent/persistent high-grade intraepithelial lesions and cervical stenosis after therapeutic conization: a retrospective analysis of 522 cases

Combined application of diclofenac and celecoxib with an opioid yields superior efficacy in metastatic bone cancer pain: a randomized controlled trial

Keynote webinar | Spotlight on antibody–drug conjugates in cancer