Can the neutrophil‐to‐lymphocyte ratio be used to predict recurrence and progression of non‐muscle‐invasive bladder cancer?

Abstract

The aim of our study was to evaluate whether neutrophil-to-lymphocyte ratio (NLR) is a predictor of disease progression and recurrence in patients with primary non-muscle-invasive bladder cancer (NMIBC). This was a prospective study of 86 patients with newly diagnosed NMIBC. The patients were classified by the number of points assigned by the European Organization for Research and Treatment of Cancer risk tables. The correlation between progression score, recurrence score, age, mean platelet volume, red blood cell distribution width and NLR was assessed statistically. The same parameters were compared between the risk groups. A significant difference in NLR and age values was observed between recurrence and progression risk score groups. The relationships between NLR and recurrence and progression risk scores were no longer significant after correcting for the statistical effect of age on scores. Age was significantly different between groups after adjusting for NLR. Our study revealed that NLR and age were associated with patient age and bladder tumor progression and recurrence risk scores. After correcting for age, the significant relationship with NLR was lost, in contrast to some previous studies. We recommend that patient age should be corrected to avoid misleading results in NLR studies.

Preoperative neutrophil to lymphocyte ratio can improve disease progression prediction of non-muscle invasive bladder cancer

“…Sebahattin et al, argued that correction for age might alter the results, so an analysis of covariance was performed (ANCOVA) to test whether age would significantly affect the relationship between NLR > 2.5 and disease progression. For our data, age was not found significant (p = 0.297) [23].…”

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

“…Third, significant publication bias could be identified among the studies of OS, RFS, PFS and DSS/CSS in bladder cancer patients according to Begg’s and Egger’s tests. Most of the included studies reported that an elevated pre-treatment NLR significantly correlated with a poor prognosis in bladder cancer patients, and some studies with neutral results were not included due to insufficient data [58, 59], which may contribute to the publication bias. Trim and fill analyses were performed to estimate the missing publications, and the filled analyses validated our results in both fixed- and random-effects models.…”

Elevated neutrophil‑to‑lymphocyte ratio is associated with nutritional impairment, immune suppression, resistance to S‑1 plus cisplatin, and poor prognosis in patients with stage?IV gastric cancer

“…Based on these findings, a number of inflammation-based prognostic markers such as the Glasgow Prognostic Score (GPS) and the platelet to lymphocyte ratio (PLR) have been studied (6,7). In addition, Elevated neutrophil-to-lymphocyte ratio is associated with nutritional impairment, immune suppression, resistance to S-1 plus cisplatin, and poor prognosis in patients with stage IV gastric cancer KENJI GONDA 1,2 , MASAHIKO SHIBATA there is increasing evidence that the neutrophil to lymphocyte ratio (NLR) can be an effective prognostic indicator in various types of malignant diseases (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In cancer patients, lymphopenia reflects an impaired cell-mediated immunity, while neutrophilia is acknowledged as a response to systemic inflammation.…”