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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2016

01-01-2016 | Urologic Oncology

The Prognostic Significance of Inflammation-Associated Blood Cell Markers in Patients with Upper Tract Urothelial Carcinoma

Authors: Yen-Chen Cheng, BS, Chun-Nung Huang, MD, PhD, Wen-Jeng Wu, MD, PhD, Ching-Chia Li, MD, Hung-Lung Ke, MD, MS, Wei-Ming Li, MD, MS, Hung-Pin Tu, PhD, Chien-Feng Li, MD, Lin-Li Chang, PhD, Hsin-Chih Yeh, MD, MS

Published in: Annals of Surgical Oncology | Issue 1/2016

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Abstract

Background

Inflammation-related parameters based on blood cells, including white blood cell (WBC) count, neutrophil–lymphocyte ratio, platelet count, and red cell distribution width (RDW), have been shown to be associated with prognosis in many cancers. However, no previous study evaluated these inflammation-associated markers simultaneously in upper tract urothelial carcinoma (UTUC).

Methods

A total of 195 patients with UTUC who received radical nephroureterectomy between 2005 and 2010 were included retrospectively as the derivation cohort to investigate the impact of inflammation markers on overall survival (OS) and cancer-specific survival (CSS). In turn, another independent set of 225 patients were used for validation. Finally, we performed survival analysis in the combined cohort consisting of 420 UTUC patients.

Results

The predictive value of RDW and WBC count on outcome was replicable in different cohorts. Multivariate analysis showed high RDW was independently associated with poor OS (P < 0.001), and WBC count was a significant prognosticator for both OS and CSS (both P < 0.001). In subgroup analysis, we found the prognostic significance of RDW for OS was limited in organ-confined disease (≤pT2 without pN+). More importantly, a clear survival difference can be demonstrated by combining RDW and WBC count with other known prognostic factors in the risk stratification model.

Conclusions

RDW and WBC count have the advantage of their common accessibility and are useful markers to predict outcome of UTUC in the preoperative setting. RDW and WBC count could provide additional prognostic value and help physicians identify patients at high risk for mortality and formulate individualized treatment strategy.
Appendix
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Metadata
Title
The Prognostic Significance of Inflammation-Associated Blood Cell Markers in Patients with Upper Tract Urothelial Carcinoma
Authors
Yen-Chen Cheng, BS
Chun-Nung Huang, MD, PhD
Wen-Jeng Wu, MD, PhD
Ching-Chia Li, MD
Hung-Lung Ke, MD, MS
Wei-Ming Li, MD, MS
Hung-Pin Tu, PhD
Chien-Feng Li, MD
Lin-Li Chang, PhD
Hsin-Chih Yeh, MD, MS
Publication date
01-01-2016
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4781-z

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