Promising role of preoperative neutrophil-to-lymphocyte ratio in patients treated with radical nephroureterectomy.

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State: Public
Version: author
Serval ID
serval:BIB_24DDB6EC6BD8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Promising role of preoperative neutrophil-to-lymphocyte ratio in patients treated with radical nephroureterectomy.
Journal
World journal of urology
Author(s)
Vartolomei M.D., Mathieu R., Margulis V., Karam J.A., Rouprêt M., Lucca I., Mbeutcha A., Seitz C., Karakiewicz P.I., Fajkovic H., Wood C.G., Weizer A.Z., Raman J.D., Rioux-Leclercq N., Haitel A., Bensalah K., Rink M., Briganti A., Xylinas E., Shariat S.F.
ISSN
1433-8726 (Electronic)
ISSN-L
0724-4983
Publication state
Published
Issued date
01/2017
Peer-reviewed
Oui
Volume
35
Number
1
Pages
121-130
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Several retrospective studies with small cohorts reported neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU). We aimed at validating the predictive and prognostic role of NLR in a large multi-institutional cohort.
Preoperative NLR was assessed in a multi-institutional cohort of 2477 patients with UTUC treated with RNU. Altered NLR was defined by a ratio >2.7. Logistic regression analyses were performed to assess the association between NLR and lymph node metastasis, muscle-invasive and non-organ-confined disease. The association of altered NLR with recurrence-free survival (RFS) and cancer-specific survival (CSS) was evaluated using Cox proportional hazards regression models.
Altered NLR was observed in 1428 (62.8 %) patients and associated with more advanced pathological tumor stage, lymph node metastasis, lymphovascular invasion, tumor necrosis and sessile tumor architecture. In a preoperative model that included age, gender, tumor location and architecture, NLR was an independent predictive factor for the presence of lymph node metastasis, muscle-invasive and non-organ-confined disease (p < 0.001). Within a median follow-up of 40 months (IQR 20-76 months), 548 (24.1 %) patients experienced disease recurrence and 453 patients (19.9 %) died from their cancer. Compared to patients with normal NLR, those with altered NLR had worse RFS (0.003) and CSS (p = 0.002). In multivariable analyses that adjusted for the effects of standard clinicopathologic features, altered NLR did not retain an independent value. In the subgroup of patients treated with lymphadenectomy in addition to RNU, NLR was independently associated with CSS (p = 0.03).
In UTUC, preoperative NLR is associated with adverse clinicopathologic features and independently predicts features of biologically and clinically aggressive UTUC such as lymph node metastasis, muscle-invasive or non-organ-confined status. NLR may help better risk stratify patients with regard to lymphadenectomy and conservative therapy.

Pubmed
Open Access
Yes
Create date
06/06/2016 16:21
Last modification date
20/08/2019 13:03
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