David D'Andrea1, Marco Moschini1,2, Kilian M Gust1,3, Mohammad Abufaraj1, Mehmet Özsoy1, Romain Mathieu4, Francesco Soria5, Alberto Briganti2, Morgan Rouprêt6, Pierre I Karakiewicz7, Shahrokh F Shariat1,3,8. 1. Department of Urology, Medical University of Vienna, Vienna, Austria. 2. Urological Research Institute, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. 3. Karl Landsteiner University, Krems an der Donau, Austria. 4. Department of Urology, Rennes University Hospital, Rennes, France. 5. Department of Urology, University of Turin, Turin, Italy. 6. Department of Urology, Pitié-Salpétrière Hospital, APHP, University Paris VI, Paris, France. 7. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada. 8. Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York.
Abstract
PURPOSE: To evaluate the role of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as pre-operative markers for predicting extravesical disease and survival outcomes in patients undergoing radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS: Data from 4335 patients undergoing RC for clinically non-metastatic UCB were analyzed. Multivariable logistic regression models were used to predict lymph node involvement and extravesical disease (defined as ≥pT3 and N0). Recurrence-free (RFS), cancer-specific (CSS), and overall survival (OS) were evaluated using multivariable Cox models. The accuracy of the models was assessed with receiver operating characteristics (ROC) curves and concordance-index. RESULTS: Median LMR was 3.5 and median NLR was 2.7. Addition of LMR and NLR to a standard preoperative model improved its discrimination for prediction of lymph node metastasis by 4.5%. On multivariable analysis LMR and NLR independently predicted RFS, CSS, and OS. The discrimination of this model increased by adding LMR and NLR but was not significant. CONCLUSIONS: LMR and NLR independently improved the preoperative prediction of lymph node metastasis and survival outcomes. As they are readily available, they could be integrated in a panel of preoperative markers helping selecting patients who have extravesical lymph node involvement and more aggressive disease.
PURPOSE: To evaluate the role of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as pre-operative markers for predicting extravesical disease and survival outcomes in patients undergoing radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS: Data from 4335 patients undergoing RC for clinically non-metastatic UCB were analyzed. Multivariable logistic regression models were used to predict lymph node involvement and extravesical disease (defined as ≥pT3 and N0). Recurrence-free (RFS), cancer-specific (CSS), and overall survival (OS) were evaluated using multivariable Cox models. The accuracy of the models was assessed with receiver operating characteristics (ROC) curves and concordance-index. RESULTS: Median LMR was 3.5 and median NLR was 2.7. Addition of LMR and NLR to a standard preoperative model improved its discrimination for prediction of lymph node metastasis by 4.5%. On multivariable analysis LMR and NLR independently predicted RFS, CSS, and OS. The discrimination of this model increased by adding LMR and NLR but was not significant. CONCLUSIONS: LMR and NLR independently improved the preoperative prediction of lymph node metastasis and survival outcomes. As they are readily available, they could be integrated in a panel of preoperative markers helping selecting patients who have extravesical lymph node involvement and more aggressive disease.
Authors: Victor M Schuettfort; David D'Andrea; Fahad Quhal; Hadi Mostafaei; Ekaterina Laukhtina; Keiichiro Mori; Frederik König; Michael Rink; Mohammad Abufaraj; Pierre I Karakiewicz; Stefano Luzzago; Morgan Rouprêt; Dmitry Enikeev; Kristin Zimmermann; Marina Deuker; Marco Moschini; Reza Sari Motlagh; Nico C Grossmann; Satoshi Katayama; Benjamin Pradere; Shahrokh F Shariat Journal: BJU Int Date: 2021-04-07 Impact factor: 5.969
Authors: Andrea Mari; Riccardo Campi; Riccardo Tellini; Giorgio Gandaglia; Simone Albisinni; Mohammad Abufaraj; Georgios Hatzichristodoulou; Francesco Montorsi; Roland van Velthoven; Marco Carini; Andrea Minervini; Shahrokh F Shariat Journal: World J Urol Date: 2017-11-16 Impact factor: 4.226
Authors: Jeenan Kaiser; Haocheng Li; Scott A North; Raya Leibowitz-Amit; Jo-An Seah; Nisha Morshed; Caroline Chau; Richard Lee-Ying; Daniel Y C Heng; Srikala Sridhar; Simon J Crabb; Nimira S Alimohamed Journal: Bladder Cancer Date: 2018-04-26