Predictive value of preoperative neutrophil-to-lymphocyte ratio on the prognosis of germ cell testicular tumors

Bolat, Deniz; Aydoğdu, Özgü; Polat, Salih; Yarımoğlu, Serkan; Bozkurt, İbrahim Halil; Yonguç, Tarık; Şen, Volkan

doi:10.5152/tud.2016.38924

Cited by 23 publications

(21 citation statements)

References 25 publications

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“…In their study, Yuksel et al defined a cut off value of 2.06 for NLR in localized TGCT similar to our finding (18). Bolat et al defined optimal cut off value of NLR for progression free survival as 3.55 and for cancer specific survival as 3.0 (13).…”

Section: Discussionsupporting

confidence: 83%

“…NLR has been showed to be an independent risk factor in various other urological tumors such as renal cancer, bladder cancer, upper tract urothelial carcinoma and prostate cancer (21). There is only one study regarding the predictive value of NLR on the prognosis of TGCT (13). Fifty-three patients with germ cell tumor were evaluated and no relationship was found between preoperative NLR and cancer specific survival or progression free survival.…”

Section: Discussionmentioning

confidence: 99%

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The relationship of neutrophil to lymphocyte ratio with testicular cancer

et al. 2020

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Purpose: To assess the relationship between testicular germ cell tumors (TGCT) and neutrophil to lymphocyte ratio (NLR) and to determine whether this ratio can be used as a serum tumor marker. Material and Methods: Sixty-one patients with testicular germ cell tumors were included into the study. Patients were grouped as localized and non-localized. Histologically patients were categorized as seminoma and nonseminomatous germ cell tumors. Complete blood cell count was measured the day before surgery and at the postoperative 1st month. Preoperative and postoperative mean NLR values were compared. Results: Thirty-six patients (59%) had seminomas and 25 patients (41%) had nonseminomatous testicular cancer. Forty-fi ve patients (73.8%) had localized and 16 patients (26.2%) had non-localized testicular cancer. There was a statistically signifi cant difference between preoperative and postoperative mean NLR of the localized patients (p=0.001) but no such difference was detected for non-localized patients (p=0.576). Nineteen patients with localized seminomas had normal preoperative serum tumor markers. There was a signifi cant difference between preoperative and postoperative mean NLR in this group of patients (p=0.010). Twenty-six patients with localized tumors had preoperative increased serum tumor markers which normalized after orchiectomy. Mean NLR of these patients signifi cantly decreased from 3.10±2.13 to 1.62±0.59 postoperatively (p=0.010).Conclusions: NLR appears to be a useful marker for TGCT. It is successful in predicting localized and non-localized disease in early postoperative period.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

The relationship of neutrophil to lymphocyte ratio with testicular cancer

et al. 2020

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“…Complete blood count parameters were also utilized to establish practical markers in the diagnosis and prediction of prognosis of testicular cancer [16,17]. In a study by Yuksel et al, [16] neutrophil-to-lymphocyte ratio was found significantly higher in patients with testicular cancer compared to controls, 3.18 ± 1.76 versus 1.99 ± 1.17, p < 0.001.…”

Section: Discussionmentioning

confidence: 99%

“…They suggested white blood cell counts and neutrophil-to-lymphocyte ratio as the practical test in testicular cancer diagnosis besides well-known testicular cancer markers such as AFP, hCG, and LDH. Bolat et al [17] investigated the prognostic value of neutrophil-to-lymphocyte ratio in germ cell testicular cancer, however they found that neutrophil-to-lymphocyte ratio does not predict germ cell testicular cancer prognosis. In the present study, besides serum testicular tumor markers (AFP and hCG) higher (> 1.35) De Ritis ratio was found to be associated with worse prognosis in testicular cancer but not with worse pathological outcomes.…”

Section: Discussionmentioning

confidence: 99%

The utility of De Ritis Ratio in predicting prognosis in testicular cancer

et al. 2020

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Objective We aimed to investigate the possible association between testicular cancer prognosis and De Ritis ratio (AST/ALT). Methods The medical records of all patients who underwent radical inguinal orchiectomy at a single tertiary in Istanbul, Turkey between 2006 and 2017 were retrospectively analyzed. Investigated parameters included patients’ demographics, complete blood count and blood biochemistry results, pathology results, treatment schemes, imaging results, and survival. De Ritis ratio was calculated as follows: AST/ALT. Results A total of 171 patients with a mean age of 32.6 ± 10.1 years were included in the study. 73 patients had T1, 83 had T2, 13 had T3 and 2 had T4 disease. Rete testis invasion was detected in 74 patients (43.3 %) as well as lymphovascular invasion in 93 (54.4 %) and tunica albuginea invasion in 80 (46.8 %) patients. The cut-off value for AST/ALT was set at 1.35 [Area Under Curve (AUC): 0.791 with a sensitivity of 80 % and specificity of 73 %]. No statistically significance was observed between patients with and without elevated AST/ALT according to rete testis invasion, lymphovascular invasion, tunica albuginea invasion, and tunica vaginalis invasion (p = .25, p = .63, p = 1.0 and p = 1.0, respectively). 28.2 % of patients with seminoma had AST/ALT > 1.35 however 41.9 % of patients with non-seminoma pathology had AST/ALT > 1.35 (p = .078). Mean estimated survival time of patients with AST/ALT > 1.35 was higher than those with AST/ALT < 1.35, 91.8 versus 70.4 months, p < .001). As seen in Kaplan-Meier analysis elevated AST/ALT is associated with early-term mortality. Conclusion De Ritis ratio was shown to be significantly associated with unfavorable prognosis. De Ritis ratio might serve as a prognostic biomarker in testicular tumor besides well-known tumor markers such as beta-human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH).

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“…Similar to our findings, no significant relation between NLR and tumor stage or prognostic factors related to occult metastasis, like rete testis invasion and/ or lymphovascular invasion, was obtained. However, the average sample size and inclusion of distant organ metastatic patients to such a small group, made the clinical evaluation of their data difficult and query (18).…”

Section: Discussionmentioning

confidence: 99%

Predictive and prognostic impact of preoperative complete blood count based systemic inflammatory markers in testicular cancer

et al. 2020

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Purpose: To determine the utility of preoperative complete blood count (CBC) based systemic infl ammatory markers in the prediction of testicular cancer and its prognosis. Material and Methods: Between 2008-2017 the data of all testicular tumor patients undergoing radical orchiectomy were retrospectively analyzed. Patient baseseline characteristics (age, tumor stage, tumor markers, etc.) and results of routine preoperative blood tests including mean platelet volume (MPV), red cell distribution width (RDW), lymphocyte ratio (LR) and neutrophil ratio (NR) were retrieved. In addition, neutrophil to lymphocyte ratio (NLR) was calculated. Results: Mean age of the tumor and control group was 36.0±15 and 30.50±11 years, respectively. Mean RDW, NR and NLR were signifi cantly higher in the tumor group with p values<0.001; whereas LR and MPV were signifi cantly higher in the control group (p<0.001). Receiver Operating Characteristic (ROC) analyses of LR, NR, RDW, MPV, and NLR are shown in Table-3. The cut off values for RDW and NR were found as 13,7 (Area under the curve (AUC): 0.687, sensitivity = 42.2%, specifi city = 84.8%) and 55.3 (AUC:0.693, sensitivity 72.2%, specifi city 62%), respectively. Area under the curve for NLR in tumor group was 0.711, with a threshold value of 1.78 and sensitivity=81.8% and specifi city=55.4% (AUC:0.711/sig<0.001) that together with RDW exhibited the best differential diagnosis potential which could be used as an adjuvant tool in the prediction of testicular tumor and its prognosis. Conclusion: Several systemic infl ammatory markers, which are obtained by routinely performed cost-effective blood tests, could demonstrate incremental predictive and prognostic information adjuvant to preoperativly achieved testiscular tumor markers.

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Predictive value of preoperative neutrophil-to-lymphocyte ratio on the prognosis of germ cell testicular tumors

Cited by 23 publications

References 25 publications

The relationship of neutrophil to lymphocyte ratio with testicular cancer

The relationship of neutrophil to lymphocyte ratio with testicular cancer

The utility of De Ritis Ratio in predicting prognosis in testicular cancer

Predictive and prognostic impact of preoperative complete blood count based systemic inflammatory markers in testicular cancer

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