Sumin Son1, Eu-Chang Hwang2, Seung-Il Jung1, Dong-Deuk Kwon1, Seock-Hwan Choi3, Tae-Gyun Kwon3, Joon-Hwa Noh4, Myung-Ki Kim5, Ill-Young Seo6, Chul-Sung Kim7, Sung-Gu Kang8, Jun Cheon8, Hong-Koo Ha9, Chang-Wook Jeong10, Ja-Hyeon Ku10, Cheol Kwak10, Hyeon-Hoe Kim10. 1. Department of Urology, Chonnam National University Medical School, Gwangju, South Korea. 2. Department of Urology, Chonnam National University Medical School, Gwangju, South Korea - urohwang@gmail.com. 3. Department of Urology, Kyungpook National University School of Medicine, Daegu, South Korea. 4. Department of Urology, Kwangju Christian Hospital, Gwangju, South Korea. 5. Department of Urology, Chonbuk National University Medical School, Jeonju, South Korea. 6. Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea. 7. Department of Urology, Chosun University School of Medicine, Gwangju, South Korea. 8. Department of Urology, Korea University College of Medicine, Seoul, South Korea. 9. Department of Urology, Pusan National University School of Medicine, Busan, South Korea. 10. Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
Abstract
BACKGROUND: The aim of this study was to investigate the prognostic value of preoperative systemic inflammation markers in upper tract urothelial carcinoma (UTUC). METHODS: A total of 1137 patients who underwent radical nephroureterectomy with bladder cuff excision at 9 institutions from 2004 to 2015, were retrospectively reviewed. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for each patient were calculated. Univariable and multivariable analysis was performed using the Cox proportional hazards regression model. Cut-off values for NLR and PLR were calculated using a receiver operating characteristic curve. RESULTS: The median follow-up period was 39.1 (interquartile range: 18.3-63.8) months. Univariable analysis revealed that GPS, mGPS, PLR, and NLR (all, P=0.001) were significantly associated with both recurrence-free survival (RFS) and cancer-specific survival (CSS). Multivariable analysis revealed that GPS (P=0.001), PLR (hazards ratio [HR] =1.32; 95% CI: 1.08-1.62, P=0.007 and HR =1.87; 95% CI: 1.21-2.92, P=0.005), NLR (HR =1.38; 95% CI: 1.12-1.69, P=0.003 and HR =1.70; 95% CI: 1.10-2.62, P=0.017) were significantly associated with RFS and CSS. CONCLUSIONS: Our results suggest that preoperative systemic inflammation markers such as GPS, PLR, and NLR are independent prognostic factors in patients with UTUC after surgery.
BACKGROUND: The aim of this study was to investigate the prognostic value of preoperative systemic inflammation markers in upper tract urothelial carcinoma (UTUC). METHODS: A total of 1137 patients who underwent radical nephroureterectomy with bladder cuff excision at 9 institutions from 2004 to 2015, were retrospectively reviewed. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for each patient were calculated. Univariable and multivariable analysis was performed using the Cox proportional hazards regression model. Cut-off values for NLR and PLR were calculated using a receiver operating characteristic curve. RESULTS: The median follow-up period was 39.1 (interquartile range: 18.3-63.8) months. Univariable analysis revealed that GPS, mGPS, PLR, and NLR (all, P=0.001) were significantly associated with both recurrence-free survival (RFS) and cancer-specific survival (CSS). Multivariable analysis revealed that GPS (P=0.001), PLR (hazards ratio [HR] =1.32; 95% CI: 1.08-1.62, P=0.007 and HR =1.87; 95% CI: 1.21-2.92, P=0.005), NLR (HR =1.38; 95% CI: 1.12-1.69, P=0.003 and HR =1.70; 95% CI: 1.10-2.62, P=0.017) were significantly associated with RFS and CSS. CONCLUSIONS: Our results suggest that preoperative systemic inflammation markers such as GPS, PLR, and NLR are independent prognostic factors in patients with UTUC after surgery.