Abstract:
:Previously, the preoperative neutrophil-to-lymphocyte ratio (NLR) has been demonstrated to be a beneficial prognostic marker in patients with upper tract urothelial carcinoma (UTUC). However, to the best of our knowledge, the postoperative NLR has rarely been investigated. Therefore, the present study evaluated the prognostic significance of postoperative NLR in patients with UTUC. Data of patients with UTUC who underwent surgical treatment at Kurume University hospital (Kurume, Japan) between 2004 and 2015 were retrospectively reviewed. Clinicopathological characteristics were analyzed, including pre- and postoperative NLRs. Overall survival (OS) and cancer-specific survival (CSS) rates were estimated using the Kaplan-Meier method and compared with a log-rank test. Multivariate proportional Cox regression models were applied for both endpoints to identify the independent prognostic significance of NLR. The median age of the 134 enrolled patients was 70 years. The postoperative NLR was elevated in 35 patients (26.1%). A high postoperative NLR of ≥2.5 was significantly associated with a high postoperative C-reactive protein level of ≥0.3 mg/dl, an advanced pathological T stage and positive lymphovascular invasion in surgical specimens (P<0.001, P=0.019 and P=0.024, respectively). The 5-year OS rates in patients with high and low postoperative NLR were 33.7 and 70.2%, respectively (P<0.001), and the 5-year CSS rates in patients with a high and low postoperative NLR were 33.7 and 80.7%, respectively (P<0.001). Multivariate analysis revealed that a high postoperative NLR was an independent prognostic marker for OS (hazard ratio, 4.66; 95% confidence interval, 2.11-10.00; P<0.001) and CSS (hazard ratio, 10.90; 95% confidence interval, 4.32-28.40; P<0.001), and the preoperative NLR was not identified as a prognostic marker. In conclusion, a high postoperative NLR is associated with a poor prognosis in patients with UTUC. Therefore, postoperative NLR may be a potential prognostic marker in patients with UTUC undergoing nephroureterectomy.
journal_name
Oncol Lettjournal_title
Oncology lettersauthors
Nishihara K,Suekane S,Ueda K,Nakiri M,Matsuo M,Igawa Tdoi
10.3892/ol.2019.10178subject
Has Abstractpub_date
2019-06-01 00:00:00pages
5241-5250issue
6eissn
1792-1074issn
1792-1082pii
OL-0-0-10178journal_volume
17pub_type
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