PROGNOSTIC SIGNIFICANCE OF PARAMETERS ARISING FROM THE RATIO OF NEUTROPHILS AND LYMPHOCYTES IN INVASVIE BLADDER NEOPLASMS
Authors:
Natália Marečková 1; Michal Staník 1; Ivo Čapák 1; Daniel Macík 1; Jiří Jarkovský 2; Denisa Malúšková 2; Jan Doležel 1
Authors‘ workplace:
Oddělení onkourologie, Masarykův onkologický ústav, Brno
1; Institut biostatistiky a analýz, Masarykova univerzita, Brno
2
Published in:
Ces Urol 2016; 20(4): 293-301
Category:
Original Articles
Overview
Major statement:
Elevated lymphocyte to neutrophile ratio as a marker of systemic inflammation, was confirmed as negative predictors of cancer-specific survival in the group of 110 patients, who underwent radical cystectomy for invasive urothelial carcinoma of urinary bladder.
Aims:
The aim of our study was to investigate the prognostic impact of the longitudinal monitoring of markers of systemic inflammation neutrophil-to-lymphocyte ratio (NLR, derived NLR) in patients undergoing radical cystectomy.
Patients and methods:
In the period 2006. 2014 110 patients with bladder cancer underwent radical cystectomy without neoadjuvant chemotherapy. Results of blood count before, and 3.5 months after surgery, and at the time of diagnosis of relapse, were obtained retrospectively, and parameters of NLR and dNLR were analyzed. Patients were divided in two groups according to the NLR and dNLR with the cut-off values of 3.9 and 2.7 respectively. The prognostic impact of these parameters on patientse survival was assessed.
Results:
Postoperative elevation od both NLR and dNLR was a negative predictor of cancer-specific survival. Five year cancer-specific survival was 64 % in patients with NLR . 3.9 compared to 42 % in those with NLR > 3.9 (HR 2.0; p=0.043). Similarly, in case of dNLR, with the cut-off value of 2.7, the survival rates in the groups were 63% and 30% respectively (HR 3.7; p=0.002). Pre-operative values of both parameters showed no prognostic significance. At the time of relapse, higher values of NLR and dNLR were associated with shorter survival (median 4 and 3 months compared to 14 and 12 months).
Summary:
Markers of systemic inflammation showed promising results in identifying high-risk patients before surgery, as well as in follow-up. In the case of relapse, they can be helpful in prognosis prediction. In our study, the values of both NLR and dNLR obtained 3 months after surgery were of most importance, with the ability to identify the group of patients in statistically significant risk of disease progression.
Key words:
Biomarkers, prognosis, inflammation, urinary bladder neoplasms.
Sources
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Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2016 Issue 4
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