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the association between NLR and lymph node metastasis, muscle-invasive and non-organ-confined disease. The association of altered NLR with recurrence-free survival (RFS) and cancer-specific survival (CSS) was evaluated using Cox proportional hazards regression models. Results Altered NLR was observed in 1428 (62.8 %) patients and associated with more advanced pathological tumor stage, lymph node metastasis, lymphovascular invasion, tumor necrosis and sessile tumor architecture. In a preoperative model that included age, gender, tumor location and architecture, NLR was an independent predictive factor for the presence of lymph node metastasis, muscle-invasive and non-organ-confined disease AbstractObjective Several retrospective studies with small cohorts reported neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU). We aimed at validating the predictive and prognostic role of NLR in a large multi-institutional cohort. Methods Preoperative NLR was assessed in a multiinstitutional cohort of 2477 patients with UTUC treated with RNU. Altered NLR was defined by a ratio >2.7. Logistic regression analyses were performed to assess Mihai Dorin Vartolomei and Romain Mathieu have contributed equally as co-first authors.

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The primary endpoint was to assess the bladder preservation and the toxicity of bladder. This report presented the acute toxicity profile of this trimodality treatment for patients with MIBC. Materials/Methods: A total of 15 consecutive patients with cT2-4a bladder cancer underwent TURBT as complete as possible, which was visibly complete in 10 cases. They received hypo-fractionated radiotherapy (12 Gy in 2 fractions) to tumor or tumor bed in bladder followed by conventional fractionated radiotherapy (50 Gy in 25 fractions) to pelvis and total bladder, and concurrent infusion Gemcitabine 100 mg/m 2 per week during radiotherapy. During the two hypo-fractions, intravesical installation of isovolumetric saline through urinary catheter ensured adequate bladder filling. Of the 15 patients, 2 subsequently received 3 cycles of adjuvant chemotherapy, consisting of Gemcitabine and Cisplatin. Patients were reevaluated by the means of cystoscopy and pelvic CT or MRI at 1 month and then every 3 months. Toxicities were assessed using Common Terminology Criteria for Adverse Events (CTCAE) 4.0. Results: The median follow-up for the entire group was 11 (1.5-20.8) months. The median age was 72 (39-78). Of the 15 patients, 1 died due to distant metastasis, and 14 were alive with disease-free intact bladder. During radiotherapy, 1 patient (6.7%) complained of Grade 3 diarrhea, 3 patients (20.0%) complained of Grade 2 diarrhea. 2 patients (13.3%) reported Grade 2 urinary frequency and urinary urgency, but recovered to Grade 0-1 within one month after radiotherapy. 3 patients (20%) complained of urinary moderate pain after radiotherapy and recovered to mild after one month. 1 patient (6.7%) complained of small bladder (150ml) after 6 months follow-up. None of patients reported gross hematuria and urinary incontinence. Conclusion: This combined partial hypo-fractionated radiation/chemotherapy regimen with TURBT appears to be a well-tolerable and effective treatment strategy for MIBC patients who are not candidates for cystectomy or who wish to avoid cystectomy, and this trimodality treatment warrants further investigation.