Preoperative Neutrophil/Lymphocyte Ratio Predicts Overall Survival and Extravesical Disease in Patients Undergoing Radical Cystectomy

Krane, L. Spencer; Richards, Kyle A.; Kader, A. Karim; Davis, Ronald L.; Balaji, K.C.; Hemal, Ashok K.

doi:10.1089/end.2012.0606

Cited by 90 publications

(82 citation statements)

References 24 publications

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“…Gondo et al [29] observed that NLR was an independent prognostic factor with a NLR cut-off value of 2.5. With a similar cut-off value, Krane et al [30] reported that the patients with elevated NLR before RC have worse overall survival than patients without markers of systemic inflammation. In another study, Kang et al [31] revealed that postoperative NLR during the early recovery period demonstrated prognostic significance for bladder cancer patients undergoing RC with pelvic lymph node dissection with a NLR cut-off value of 2.…”

Section: Discussionmentioning

confidence: 99%

Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

Şefik

Günlüsoy

Aydoğdu

et al. 2018

Turkish Journal of Urology

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Objective: The aim of this study is to examine the usefulness of preoperative neutrophile-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratios to predict pathological upstaging of invasive bladder cancer who underwent radical cystectomy. Material and methods:A total of 126 patients who underwent radical cystectomy at our clinic between January 2006 and March 2015 were retrospectively analysed. One hundred and twelve patients with organconfined invasive bladder tumors (T2) detected at histopathological examination of transuretral resection material were included in the study. Upstaging was seen at histopathological examination of radical cystectomy specimens of 42 patients. We compared preoperative neutrophile-to-lymphocyte ratio, platelet-tolymphocyte ratio, lymphocyte-to-monocyte ratio between upstaged and not-upstaged groups.Results: There were no statistically significant correlation between age, time to radical cystectomy, gender, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio ratios and carcinoma in situ in upstaged and non-upstaged groups. Statistical analyses showed that preoperative neutrophile-to-lymphocyte ratio was higher in upstaged patients (p= 0.009). In multivariate analysis preoperative neutrophile-to-lymphocyte ratio and positive surgical margin were significantly higher in upstaged group. Conclusion:In organ-confined muscle invasive bladder cancer neutrophile-to-lymphocyte ratio seems to be an acceptable parameter to predict locally advanced disease.

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Section: Discussionmentioning

confidence: 99%

Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

Şefik

Günlüsoy

Aydoğdu

et al. 2018

Turkish Journal of Urology

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“…[16][17][18][19][20][21] In general, tumours can affect hematopoietic parameters by significant tumour bleed, or by affecting hematopoiesis through infiltration into the bone marrow or by production of pro-inflammatory cytokines and free radicals that damage hematopoietic progenitor cells, as paraneoplastic syndromes. 22 Recently, several studies reported an elevated NLR having similar prognostic significance in those with urothelial carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16] Neutrophil and lymphocyte counts were defined as 1800-7700 cells/microL and 1500-4000 cells/microL, respectively, according to WHO global standards. Leukocytosis was defined as WBC >11 000 cells/microL.…”

Section: Predictors Of Bladder Cancermentioning

confidence: 99%

The prognostic significance of preoperative leukocytosis and neutrophil-to-lymphocyte ratio in patients who underwent radical cystectomy for bladder cancer

Özcan

Telli

Öztürk

et al. 2015

CUAJ

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Introduction: We evaluated the prognostic effects of hematologic parameters of preoperative leukocytosis and neutrophil-to-lymphocyte ratio (NLR) in patients who underwent radical cystectomy for bladder cancer. Methods: We retrospectively reviewed the medical records of 363 patients who underwent radical cystectomy for bladder cancer between January 1990 and June 2013. In total, 286 patients were included in the study. Age, gender, pathologic stage, lymph node involvement, preoperative hydronephrosis, histologic subtype, surgical margin status, and lymphovascular invasion were recorded for each patient. Univariate and multivariate analysis were performed to determine the prognostic value of the preoperative clinical and laboratory parameters on disease-specific survival (DSS). Additionally, the correlation between leukocytosis and other factors were evaluated. Results: According to the univariate analysis preoperative leukocytosis and NLR were detected as negative prognostic factors on DSS. Preoperative leukocytosis, NLR, stage, lymph node involvement, histologic subtype, grade and age were independent prognostic factors for DSS, on multivariate analysis. Patients with leukocytosis had higher stage, grade and lymphovascular invasion. Conclusions: Inexpensive, reproducible, and readily available peripheral blood count components of white blood cell count and NLR were independent prognostic factors, which can stratify DSS risks in bladder cancer patients who underwent radical cystectomy.

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“…Mathematical model for predicting bladder cancer recurrence who underwent radical cystectomy for bladder cancer, elevated NLR values were associated with low survival rate [19][20][21]. Current theories claim that the systemic inflammatory response triggered by cancer includes relative neutrophillia and lymphocytopenia, which may lead to an elevated excretion of pro-angiogenic factors, growth factors, and anti-apoptotic markers by neutrophils, and a decreased intratumoral T-cell activity, leading to tumor growth and progression.…”

Section: Pol Scientificmentioning

confidence: 99%

“…Krane et al found that patients with a NLR > 2.5 had a significantly higher likelihood of extravesical bladder cancer at radical cystectomy, suggesting they may benefit from neoadjuvant chemotherapy [20]. Temraz et al showed a correlation between higher pre-operative NLR and overall survival and shorter time to recurrence in patients with muscle invasive bladder cancer undergoing cystectomy [25].…”

Section: Pol Scientificmentioning

confidence: 99%

A mathematical model for predicting tumor recurrence within 24 months following surgery in patients with T1 high-grade bladder cancer treated with BCG immunotherapy

Rubinstein

Bar-On

Bahouth

et al. 2015

Bladder

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OBJECTIVES:Aggressive bladder cancer has a high rate of recurrence and progression. Treatment of T1 high-grade (T1HG) bladder cancer lesions is challenging. Current prognostic models reasonably predict progression; however, additional prognostic markers are required to accurately predict recurrence. The aim of the study was to develop a prediction model for risk of recurrence in individual patients with T1HG bladder cancer treated with intravesical BCG. PATIENTS AND METHODS:Medical records of 115 patients with T1HG bladder cancer treated with adjuvant intravesical BCG immunotherapy from two different hospitals were reviewed. Mathematical algorithms were applied to identify parameters that could accurately predict recurrence within 24 months after surgery. RESULTS:Overall recurrence rate at 24 months after surgery was 49%. Of all clinical and pathological parameters evaluated, the best predictor of recurrence within 24 months after surgery was neutrophils-to-lymphocytes ratio. This ratio predicted recurrence with 86% sensitivity and 62% specificity in the whole database. The main limitations of our study are its retrospective nature and the small patient number.CONCLUSIONS: Neutrophils-to-lymphocytes ratio was found to be superior to traditional parameters for the prediction of recurrence within 24 months following surgery in patients with T1HG bladder cancer treated with intravesical BCG immunotherapy. Stratifying patients using risk factors can help determine the appropriate follow-up and treatment for each individual patient.

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Preoperative Neutrophil/Lymphocyte Ratio Predicts Overall Survival and Extravesical Disease in Patients Undergoing Radical Cystectomy

Cited by 90 publications

References 24 publications

Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

Predictive role of neutrophil-to-lymphocyte ratio on upstaging of organ-confined invasive urothelial bladder cancer to non-organconfined disease

The prognostic significance of preoperative leukocytosis and neutrophil-to-lymphocyte ratio in patients who underwent radical cystectomy for bladder cancer

A mathematical model for predicting tumor recurrence within 24 months following surgery in patients with T1 high-grade bladder cancer treated with BCG immunotherapy

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