MP26-16 NEUTROPHIL TO LYMPHOCYTE RATIO, A NEW PROGNOSTIC FACTOR IN NON MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive I1 Apr 2015MP26-16 NEUTROPHIL TO LYMPHOCYTE RATIO, A NEW PROGNOSTIC FACTOR IN NON MUSCLE INVASIVE BLADDER CANCER Vincenzo Favilla, Tommaso Castelli, Daniele Urzì, Sebastiano Cimino, Salvatore Privitera, Eugenia Fragalà, Giorgio Ivan Russo, and Giuseppe Morgia Vincenzo FavillaVincenzo Favilla More articles by this author , Tommaso CastelliTommaso Castelli More articles by this author , Daniele UrzìDaniele Urzì More articles by this author , Sebastiano CiminoSebastiano Cimino More articles by this author , Salvatore PriviteraSalvatore Privitera More articles by this author , Eugenia FragalàEugenia Fragalà More articles by this author , Giorgio Ivan RussoGiorgio Ivan Russo More articles by this author , and Giuseppe MorgiaGiuseppe Morgia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1138AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An elevated neutrophil to lymphocyte ratio (NLR) was associated with a worse overall and disease free survival in a variety of different malignancies, including muscle invasive bladder cancer. The predictive value of NLR in non muscle invasive bladder cancer (NMIBC) has not been well prospectively studied. The aim of our study was to evaluated whether NLR predict disease recurrence and progression in NMIBC. METHODS The NLR, defined as the absolute neutrophil count divided by the absolute lymphocyte count, was prospectively evaluated in 178 consecutive, newly diagnosed, patients with NMIBC treated with transurethral resection of the bladder tumor (TURB), between the years 2009 and 2013. Patients with hematologic disorders or conditions that may have influenced blood cell lines such as autoimmune disease, presence of an active infection and/or immunodeficiency virus infection at the time of surgical intervention, prior or concomitant intravescical therapy with BacilleCalmette– Guérin (BCG), prior blood transfusion, and the presence of other cancer types or prior chemotherapy were excluded. Cutoff points for NLR were tested separately for recurrence and progression using the standardized cutoff-finder algorithm. Univariate and multivariate Cox regression analyses were used to evaluated the association between NLR and disease recurrence and progression RESULTS The study cohort comprised 148 male and 30 female patients. The median age of all 178 patients enrolled in the study was 69.27, with a median follow-up of 53 months (IQR: 33.0-76.25). Median NLR was 2.55 (IQR: 1.90-3.62) Patients with NLR <3 were older (74.45 vs. 67.94; p=0.02) and exhibited significant differences in term of pathological stage (p=0.03) and no. of tumours (p=0.04) if compared with those with NLR ≥3. During the follow-up study, 14 (23.3%) and 44 (37.9%) (p=0.04) patients respectively with NLR <3 and ≥3 experienced recurrence and 2 (3.3%) and 14 (11.9%) experienced progression (p=0.06). At the multivariate Cox regression analysis, NLR < 3 was associated with low disease recurrence (HR: 0.34 [IQR: 0.17-0.68]; p<0.01). Pathological stage pT1 (p<0.01), high grade (p<0.01), no. of tumours (p<0.01) and smoking status (p<0.01) were independently predictors of disease recurrence. No association was found between NLR ≥ 3 and disease progression at the multivariate Cox regression analysis. The 5 years recurrence free survival was 49% and 62% in patients with NLR ≥ 3 and < 3 (p=0.04). The 5 year progression free survival was 77% and 93% in patients with NLR ≥ 3 and < 3 (p=0.69). CONCLUSIONS NLR is an independent predictor of disease recurrence but no of progression in patients with newly diagnosed NMIBC. These findings could offer a new contribution to find new biomarkers of recurrence in NMIBC patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e299-e300 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vincenzo Favilla More articles by this author Tommaso Castelli More articles by this author Daniele Urzì More articles by this author Sebastiano Cimino More articles by this author Salvatore Privitera More articles by this author Eugenia Fragalà More articles by this author Giorgio Ivan Russo More articles by this author Giuseppe Morgia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...