636 THE YIELD OF URETEROSCOPY FOR UPPER TRACT UROTHELIAL CARCINOMA IN THE ERA OF COMPUTERIZED TOMOGRAPHY UROGRAPHY

Abstract

and 72.5% at 10 years after nephroureterectomy. The mean SD NLR value was 2.83 1.35. There was no significant association between NLR and other preoperative variables. The clinical T stage and NLR were significantly associated with the MFS rate in the univariate analysis. The 5-year MFS rate in patients with NLR 3.5 was 78.1%; this rate was significantly higher than 54.2% of the patients with NLR 3.5 (p 0.0155). The multivariate analysis showed that clinical T stage (hazard ratio, 8.692; 95% confidence interval, 1.154-65.493; p 0.0358) and NLR (2.667; 1.069-6.655; p 0.0355) were independent predictors of MFS. According to the relative risk (RR) of metastasis calculated using these two variables, the patients were stratified into 3 groups (low, RR 5; intermediate, RR 5-10; high, RR 10), which have significant different prognosis. CONCLUSIONS: Preoperative elevation of NLR is an independent predictor of metastasis in patients with non-metastatic UTUC. The stratification based on T stage and NLR may be valuable for preoperative patient s counselling and for identifying patients with poor prognosis, who may be candidates for innovative treatments.