Predictive value of pretreatment inflammation-based prognostic scores (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio) for invasive bladder carcinoma

Abstract

PurposeInflammation-based prognostic scores including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are associated with oncologic outcomes in diverse malignancies. We evaluated the predictive value of pretreatment prognostic scores in differentiating nonmuscle invasive (NMIBC) and muscle invasive bladder cancer (MIBC).Materials and MethodsConsecutive transurethral resection of bladder tumour (TURBT) cases from January 2011 to December 2013 were analysed retrospectively. Patient demographics, tumour characteristics and prognostic scores results were recorded. Receiver operating characteristics curves were used to determine prognostic score cutoffs. Univariate and multivariate binomial logistic regression analysis was performed to evaluate the association between variables and MIBC.ResultsA total of 226 patients were included, with 175 and 51 having NMIBC (stages Ta and T1) and MIBC (stage T2+) groups, respectively. Median age was 75 years and 174 patients were male. The NLR cutoff was 3.89 and had the greatest area under the curve (AUC) of 0.710, followed by LMR (cutoff<1.7; AUC, 0.650) and PLR (cutoff>218; AUC, 0.642). Full blood count samples were taken a median of 12 days prior to TURBT surgery. Multivariate logistic regression analysis identified tumour grade G3 (odds ration [OR], 32.848; 95% confidence interval [CI], 9.818-109.902; p=0.000), tumour size≥3 cm (OR, 3.353; 95% CI, 1.347-8.345; p=0.009) and NLR≥3.89 (OR, 8.244; 95% CI, 2.488-27.316; p=0.001) as independent predictors of MIBC.ConclusionsNLR may provide a simple, cost-effective and easily measured marker for MIBC. It can be performed at the time of diagnostic flexible cystoscopy, thereby assisting in the planning of further treatment.

Integrative Assessment of Pretreatment Inflammation-, Nutrition-, and Muscle-Based Prognostic Markers in Patients with Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy

“…Thus, during recent decades, numerous studies of different malignancies have confirmed the associations of prognosis with various preoperative blood-based markers and physical factors, such as body mass index (BMI), nutritional status, systemic inflammation, host immunity, skeletal muscle mass (i.e., sarcopenia), and abdominal adipose tissue [4][5][6][7][8][9][10][11][12] . Moreover, the European Working Group on Sarcopenia in Older People (EWGSOP) in 2010 released a clinical definition of agerelated sarcopenia, which requires clear evidence of low muscle mass, low muscle strength, and low physical performance.…”

Diagnostic Value of Pre treatment Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Lymphocyte-to-Monocyte Ratio for Invasive Bladder Carcinoma

“…Tumour grade and tumour size were also found to be independent predictors as both are well documented prognostic indicators in bladder cancer [17] . While PLR and LMR were not identified as independent predictors of MIBC [12] . Kaynar et al [11] undertook limited analysis of PLR, and found no significant difference between mean PLR in NMIBC and MIBC (Mann-Whitney U test, p=0.810).…”

“…NLR, is an independent predictor of MIBC [12] . Tumour grade and tumour size were also found to be independent predictors as both are well documented prognostic indicators in bladder cancer [17] .…”

“…The optimum management of bladder cancer is guided by accurate staging, for which pathological analysis is the gold standard. Staging error is extremely common, with 50% of patients, at time of radical cystectomy, demonstrates upstaging [12,13] . Researchers have attempted to improve the staging process by combining histology, molecular markers and imaging modalities such as computed tomography or magnetic resonance imaging into predictive nomograms.…”

Glasgow prognostic score is superior to other inflammation-based scores in predicting survival of diffuse large B-cell lymphoma

“…Markers of host response to inflammatory, such as C-reactive protein (CRP), albumin (ALB), neutrophil, lymphocyte and platelet were reported to correlate with survival in many tumors [5,6]. Meanwhile, increasing evidence indicated that inflammation-based scores including GPS (a combination of the serum CRP and ALB), PLR (platelet lymphocyte Research Paper ratio), NLR (neutrophil lymphocyte ratio), PI (a mix of CRP and white blood cell) and PNI (Onodera's Prognostic Nutritional Index) were useful for predicting outcome in various malignancies [7][8][9][10].…”