Mihai Dorin Vartolomei1, Daniel Porav-Hodade2, Matteo Ferro3, Romain Mathieu4, Mohammad Abufaraj5, Beat Foerster6, Shoji Kimura7, Shahrokh F Shariat8. 1. Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Tirgu Mures, Romania. 2. Department of Urology, University of Medicine and Pharmacy, Tirgu Mures, Romania. 3. Division of Urology, European Institute of Oncology, Milan, Italy. 4. Department of Urology, Rennes University Hospital, Rennes, France. 5. Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. 6. Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland. 7. Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Jikei University School of Medicine, Tokyo, Japan. 8. Department of Urology, Medical University of Vienna, Vienna, Austria; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology,University of Texas Southwestern Medical Center, Dallas, TX; Department of Urology, Weill Cornell Medical College, New York, NY. Electronic address: shahrokh.shariat@meduniwien.ac.at.
Abstract
OBJECTIVE: The aim of this study was to summarize and analyze the current evidence regarding the prognostic and predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients undergoing transurethral resection of bladder tumors (TURBT) for non-muscle-invasive bladder cancer (NMIBC). MATERIAL AND METHODS: A systematic search of Web of Science, Medline/PubMed, Google Scholar, and Cochrane library was performed on the 1st of March, 2018. Studies were deemed eligible if they compared NMIBC patients with high vs. low NLR before TURBT to determine its value for prognosticating disease recurrence and progression using multivariable analysis. We performed a formal meta-analysis for both recurrence-free (RFS) and progression-free survival (PFS). RESULTS: Six studies encompassing 2,298 patients (477 [20.7%] females) assessed the prognostic value of NLR in NMIBC patients treated with TURBT. NLR predicted worse RFS (pooled HR = 1.78; 95% CI: 1.32-2.4, P<0.001) and PFS (pooled HR = 2.14; 95% CI: 1.59-2.87, P<0.001). In 4 studies encompassing 599 patients, high pretreatment NLR was associated with decreased RFS (pooled HR = 2.31; 95% CI: 1.27-4.22, P = 0.006) and in 3 of them high pretreatment NLR was associated with decreased PFS (pooled HR = 2.54; 95% CI: 1.36-4.71, P = 0.003) in high-risk NMIBC patients treated with BCG. CONCLUSION: In this meta-analysis, peripheral blood levels of NLR were associated with an increased risk of disease recurrence and progression in patients who underwent TURBT for NMIBC. Furthermore, NLR was an independent predictor of disease recurrence and progression in NMIBC treated with BCG patients. NLR could be used to improve clinical decision-making regarding treatment and follow-up scheduling.
OBJECTIVE: The aim of this study was to summarize and analyze the current evidence regarding the prognostic and predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients undergoing transurethral resection of bladder tumors (TURBT) for non-muscle-invasive bladder cancer (NMIBC). MATERIAL AND METHODS: A systematic search of Web of Science, Medline/PubMed, Google Scholar, and Cochrane library was performed on the 1st of March, 2018. Studies were deemed eligible if they compared NMIBC patients with high vs. low NLR before TURBT to determine its value for prognosticating disease recurrence and progression using multivariable analysis. We performed a formal meta-analysis for both recurrence-free (RFS) and progression-free survival (PFS). RESULTS: Six studies encompassing 2,298 patients (477 [20.7%] females) assessed the prognostic value of NLR in NMIBC patients treated with TURBT. NLR predicted worse RFS (pooled HR = 1.78; 95% CI: 1.32-2.4, P<0.001) and PFS (pooled HR = 2.14; 95% CI: 1.59-2.87, P<0.001). In 4 studies encompassing 599 patients, high pretreatment NLR was associated with decreased RFS (pooled HR = 2.31; 95% CI: 1.27-4.22, P = 0.006) and in 3 of them high pretreatment NLR was associated with decreased PFS (pooled HR = 2.54; 95% CI: 1.36-4.71, P = 0.003) in high-risk NMIBC patients treated with BCG. CONCLUSION: In this meta-analysis, peripheral blood levels of NLR were associated with an increased risk of disease recurrence and progression in patients who underwent TURBT for NMIBC. Furthermore, NLR was an independent predictor of disease recurrence and progression in NMIBC treated with BCG patients. NLR could be used to improve clinical decision-making regarding treatment and follow-up scheduling.
Authors: M Ferro; G Di Lorenzo; M D Vartolomei; D Bruzzese; F Cantiello; G Lucarelli; G Musi; S Di Stasi; R Hurle; G Guazzoni; G M Busetto; A Gabriele; F Del Giudice; R Damiano; F Perri; S Perdona; P Verze; M Borghesi; R Schiavina; G L Almeida; P Bove; E Lima; R Autorino; N Crisan; A R Abu Farhan; M Battaglia; G I Russo; Vincenzo Ieluzzi; G Morgia; P De Placido; D Terracciano; A Cimmino; L Scafuri; V Mirone; O De Cobelli; S Shariat; Guru Sonpavde; C Buonerba Journal: World J Urol Date: 2019-04-16 Impact factor: 4.226
Authors: Austin Martin; Benjamin L Woolbright; Shahid Umar; Molly A Ingersoll; John A Taylor Journal: Nat Rev Urol Date: 2022-07-07 Impact factor: 16.430