The Neutrophil-to-lymphocyte Ratio as a Prognostic Factor for Patients with Urothelial Carcinoma of the Bladder Following Radical Cystectomy: Validation and Meta-analysis.

Détails

ID Serval
serval:BIB_5B2803795184
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The Neutrophil-to-lymphocyte Ratio as a Prognostic Factor for Patients with Urothelial Carcinoma of the Bladder Following Radical Cystectomy: Validation and Meta-analysis.
Périodique
European urology focus
Auteur(s)
Lucca I., Jichlinski P., Shariat S.F., Rouprêt M., Rieken M., Kluth L.A., Rink M., Mathieu R., Mbeutcha A., Maj-Hes A., Fajkovic H., Briganti A., Seitz C., Karakiewicz P.I., de Martino M., Lotan Y., Babjuk M., Klatte T.
ISSN
2405-4569 (Electronic)
ISSN-L
2405-4569
Statut éditorial
Publié
Date de publication
04/2016
Peer-reviewed
Oui
Volume
2
Numéro
1
Pages
79-85
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The neutrophil-to-lymphocyte ratio (NLR) as a marker of systemic inflammatory response has been proposed as a prognostic factor for patients with urothelial carcinoma of the bladder (UCB) following radical cystectomy (RC).
To validate NLR as a prognostic biomarker and to perform a pooled meta-analysis.
The NLR was assessed in 4061 patients within 30 days before RC. A systematic review of the literature was undertaken using electronic databases.
Associations with overall survival (OS) and cancer-specific survival (CSS) were evaluated using Cox models. Hazard ratios (HRs) were pooled in a meta-analysis using random-effects modeling.
A high NLR (≥2.7) was associated with advanced pathological tumor stages (p<0.001), lymph node involvement (p<0.001), lymphovascular invasion (p=0.008), and positive soft0tissue surgical margins (p=0.001). In multivariate analyses, a high NLR was independently associated with both OS (HR 1.11, 95% confidence interval [CI] 1.01-1.22; p=0.029) and cancer-specific survival (CSS) (HR 1.21, 95% CI 1.07-1.37, p=0.003). The discrimination of the multivariate models increased by 0.2% on inclusion of NLR. Five studies were included in the meta-analysis. The HR for NLR greater than the cutoff was 1.46 (95% CI 1.01-1.92) for OS and 1.51 (95% CI 1.17-1.85) for CSS. Limitations include the retrospective study design and the lack of standardized follow-up.
In patients with UCB treated with RC, a high preoperative NLR is associated with more advanced tumor stage, lymph node metastasis, and worse prognosis. The NLR may be a readily available and useful biomarker for preoperative prognostic stratification.
We investigated the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in patients with bladder cancer treated with radical cystectomy. We found that a high NLR is associated with worse oncologic outcomes, suggesting it could play a role in risk stratification.
Mots-clé
Meta-analysis, Neutrophil-to-lymphocyte ratio, Radical cystectomy, Survival, Urothelial carcinoma of the bladder
Pubmed
Création de la notice
17/12/2018 16:46
Dernière modification de la notice
20/08/2019 15:14
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