Mihai Dorin Vartolomei1,2,3, Shoji Kimura1,4, Matteo Ferro3, Liliana Vartolomei1, Beat Foerster1,5, Mohammad Abufaraj1,6, Shahrokh F Shariat7,8,9,10. 1. Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. 2. Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania. 3. Division of Urology, European Institute of Oncology, Milan, Italy. 4. Department of Urology, Jikei University School of Medicine, Tokyo, Japan. 5. Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland. 6. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. 7. Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at. 8. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at. 9. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. shahrokh.shariat@meduniwien.ac.at. 10. Department of Urology, Weill Cornell Medical College, New York, NY, USA. shahrokh.shariat@meduniwien.ac.at.
Abstract
BACKGROUND: Preoperative blood-based inflammatory biomarkers have been suggested to improve staging and prognostication in patients with upper-tract urothelial carcinoma (UTUC). Neutrophil-to-lymphocyte ratio (NLR) is the most studied blood-based biomarker. NLR is an indicator of systemic inflammation and has been shown to be associated with a poor prognosis in various malignancies. The aim of this study was to analyze the current evidence regarding the prognostic significance of preoperative NLR in patients undergoing radical nephroureterectomy (RNU) for UTUC to assess its prognostic potential. MATERIALS AND METHODS: A systematic search of Web of Science, Medline/PubMed and Cochrane library was performed on the 1st of October, 2017. Studies were deemed eligible if they compared patients with high NLR before surgical treatment for UTUC to patients with low NLR to determine its predictive value for survival using multivariable logistic regression analysis. We performed a formal meta-analysis for cancer-specific survival (CSS), recurrence-free survival (RFS) and overall survival (OS). RESULTS: Nine studies including a total of 4385 patients assessing the importance of NLR were included in this meta-analysis. The cut-off NLR varied in the eligible studies ranging from 2 to 3. Increased pretreatment NLR predicted OS (pooled HR 1.64 95% CI; 1.23-2.17), RFS (pooled HR 1.60 95% CI; 1.16-2.20) and CSS (pooled HR 1.73 95% CI; 1.23-2.44) in multivariable analyses. CONCLUSION: In this meta-analysis, preoperative blood-based NLR is associated with worse prognosis in patients who underwent RNU for UTUC. NLR could be used to improve clinical decision making regarding RNU vs. kidney-sparing surgery, extent of lymphadenectomy, perioperative systemic therapy and follow-up schedule.
BACKGROUND: Preoperative blood-based inflammatory biomarkers have been suggested to improve staging and prognostication in patients with upper-tract urothelial carcinoma (UTUC). Neutrophil-to-lymphocyte ratio (NLR) is the most studied blood-based biomarker. NLR is an indicator of systemic inflammation and has been shown to be associated with a poor prognosis in various malignancies. The aim of this study was to analyze the current evidence regarding the prognostic significance of preoperative NLR in patients undergoing radical nephroureterectomy (RNU) for UTUC to assess its prognostic potential. MATERIALS AND METHODS: A systematic search of Web of Science, Medline/PubMed and Cochrane library was performed on the 1st of October, 2017. Studies were deemed eligible if they compared patients with high NLR before surgical treatment for UTUC to patients with low NLR to determine its predictive value for survival using multivariable logistic regression analysis. We performed a formal meta-analysis for cancer-specific survival (CSS), recurrence-free survival (RFS) and overall survival (OS). RESULTS: Nine studies including a total of 4385 patients assessing the importance of NLR were included in this meta-analysis. The cut-off NLR varied in the eligible studies ranging from 2 to 3. Increased pretreatment NLR predicted OS (pooled HR 1.64 95% CI; 1.23-2.17), RFS (pooled HR 1.60 95% CI; 1.16-2.20) and CSS (pooled HR 1.73 95% CI; 1.23-2.44) in multivariable analyses. CONCLUSION: In this meta-analysis, preoperative blood-based NLR is associated with worse prognosis in patients who underwent RNU for UTUC. NLR could be used to improve clinical decision making regarding RNU vs. kidney-sparing surgery, extent of lymphadenectomy, perioperative systemic therapy and follow-up schedule.
Authors: Ricardo L Favaretto; Shahrokh F Shariat; Caroline Savage; Guilherme Godoy; Daher C Chade; Matthew Kaag; Bernard H Bochner; Jonathan Coleman; Guido Dalbagni Journal: BJU Int Date: 2011-06-01 Impact factor: 5.588
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Authors: Mesut Remzi; Andrea Haitel; Vitaly Margulis; Pierre Karakiewicz; Pierre Karakiewizc; Francesco Montorsi; Eiji Kikuchi; Richard Zigeuner; Alon Weizer; Christian Bolenz; Karim Bensalah; Nazareno Suardi; Jay D Raman; Yair Lotan; Matthias Waldert; Casey K Ng; Mario Fernández; Theresa M Koppie; Philipp Ströbel; Wareef Kabbani; Masaru Murai; Cord Langner; Marco Roscigno; Jeffrey Wheat; Charles C Guo; Christopher G Wood; Shahrokh F Shariat Journal: BJU Int Date: 2008-10-16 Impact factor: 5.588
Authors: Victor M Schuettfort; Benjamin Pradere; Fahad Quhal; Hadi Mostafaei; Ekaterina Laukhtina; Keiichiro Mori; Reza Sari Motlagh; Michael Rink; David D'Andrea; Mohammad Abufaraj; Pierre I Karakiewicz; Shahrokh F Shariat Journal: Turk J Urol Date: 2020-10-09
Authors: Joyce Baard; Merve Celebi; Jean de la Rosette; Antonio Alcaraz; Shahrokh Shariat; Luigi Cormio; Vítor Cavadas; M Pilar Laguna Journal: JMIR Res Protoc Date: 2020-01-24