David D'Andrea1, Marco Moschini2, Kilian Gust1, Mohammad Abufaraj1, Mehmet Özsoy1, Romain Mathieu3, Francesco Soria4, Alberto Briganti5, Morgan Rouprêt6, Pierre I Karakiewicz7, Shahrokh F Shariat8. 1. Department of Urology, Medical University of Vienna, Vienna, Austria. 2. Department of Urology, Medical University of Vienna, Vienna, Austria; Urological Research Institute, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. 3. Department of Urology, Rennes University Hospital, Rennes, France. 4. Department of Urology, University of Turin, Turin, Italy. 5. Urological Research Institute, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, 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, Medical University of Vienna, Vienna, Austria; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada; Department of Urology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Karl Landsteiner Univeristy, Krems an der Donau, Austria. Electronic address: sfshariat@gmail.com.
Abstract
INTRODUCTION: The purpose of this study was to assess the role of pretreatment neutrophil-to-lymphocyte ratio (NLR) as a predictor of clinical outcomes in patients treated with transurethral resection (TURB) for primary non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: Data from 918 patients treated with TURB for primary NMIBC were retrospectively collected. NLR was evaluated as binary variable with the cut-point of 3 based on the visual best correlation of the receiver operating curve analyses focusing on disease recurrence. The median follow-up was 62 months. Cox regression analyses were used to evaluate associations with recurrence (RFS) and progression-free survival (PFS). Subgroup analyses were done according to risk groups and receipt of intravesical bacillus Calmette-Guérin therapy. RESULTS: Overall, 293 patients had a NLR ≥ 3. High NLR was associated with pathologic T stage and smoking status. The 5-year RFS and PFS for NLR < 3 and NLR ≥ 3 were, respectively, 55.5% versus 45.9% (P = .01) and 94.9% versus 89.9% (P = .004). On multivariable analyses, NLR ≥ 3 remained significantly associated with RFS and PFS. The addition of NLR increased the discrimination of a multivariable model by 0.6% and 2.3% for RFS and PFS, respectively. Moreover, NLR showed a trend in the association with outcomes in patients treated with intravesical bacillus Calmette-Guérin therapy. CONCLUSIONS: Integration of NLR in a prediction model could be helpful in predicting RFS and PFS in patients with primary NMIBC and identifying those who are likely to fail therapy and may benefit from an early radical cystectomy. Limitations are associated to the retrospective design.
INTRODUCTION: The purpose of this study was to assess the role of pretreatment neutrophil-to-lymphocyte ratio (NLR) as a predictor of clinical outcomes in patients treated with transurethral resection (TURB) for primary non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: Data from 918 patients treated with TURB for primary NMIBC were retrospectively collected. NLR was evaluated as binary variable with the cut-point of 3 based on the visual best correlation of the receiver operating curve analyses focusing on disease recurrence. The median follow-up was 62 months. Cox regression analyses were used to evaluate associations with recurrence (RFS) and progression-free survival (PFS). Subgroup analyses were done according to risk groups and receipt of intravesical bacillus Calmette-Guérin therapy. RESULTS: Overall, 293 patients had a NLR ≥ 3. High NLR was associated with pathologic T stage and smoking status. The 5-year RFS and PFS for NLR < 3 and NLR ≥ 3 were, respectively, 55.5% versus 45.9% (P = .01) and 94.9% versus 89.9% (P = .004). On multivariable analyses, NLR ≥ 3 remained significantly associated with RFS and PFS. The addition of NLR increased the discrimination of a multivariable model by 0.6% and 2.3% for RFS and PFS, respectively. Moreover, NLR showed a trend in the association with outcomes in patients treated with intravesical bacillus Calmette-Guérin therapy. CONCLUSIONS: Integration of NLR in a prediction model could be helpful in predicting RFS and PFS in patients with primary NMIBC and identifying those who are likely to fail therapy and may benefit from an early radical cystectomy. Limitations are associated to the retrospective design.
Authors: François Audenet; Adam M Farkas; Harry Anastos; Matthew D Galsky; Nina Bhardwaj; John P Sfakianos Journal: World J Urol Date: 2018-06-02 Impact factor: 4.226
Authors: Fahad Quhal; Benjamin Pradere; Ekaterina Laukhtina; Reza Sari Motlagh; Hadi Mostafaei; Keiichiro Mori; Victor M Schuettfort; Pierre I Karakiewicz; Morgan Rouprêt; Dmitry Enikeev; Michael Rink; Mohammad Abufaraj; Shahrokh F Shariat Journal: World J Urol Date: 2021-01-26 Impact factor: 4.226