Preoperative neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predict clinical outcome in patients with muscle-invasive bladder cancer

Abstract

Objective To investigate whether the ratio of neutrophil-lymphocyte ratio (NLR) to platelet-lymphocyte ratio (PLR) can be used as a prognostic indicator for radical cystectomy (RC) for patients with muscle-invasive bladder cancer (MIBC). Methods The 132 patients with MIBC who underwent radical bladder cancer resection were divided into high NLR group (NLR 2.03, 65 cases), low NLR group (NLR<2.03, 59 cases), high PLR group (PLR 125.30, 37 cases) and low PLR group (PLR<125.30, 87 cases) according to the preoperative peripheral blood NLR and PLR. Kaplan-meier method was used to analyze the influence of each clinicopathological feature on the survival and death of patients. Log-rank test was used to compare the survival curves of NLR and PLR groups respectively. Cox regression model was used to analyze the factors affecting the prognosis of MIBC patients. Results High levels of NLR and PLR are closely related to the clinical staging of bladder cancer (χ2=4.422, P<0.05; χ2=3.115, P<0.05). In addition, univariate regression model analysis showed that both high level NLR [hazard ratio (HR)=3.503, P<0.01] and high level PLR (HR=2.688, P<0.01) could affect the 3-year survival time of bladder cancer patients, and the difference was statistically significant. Multivariate regression model analysis showed that only a high level of NLR (HR=3.678, P<0.05) was an independent risk factor for 3-year survival. Conclusion NLR is an independent risk factor for MIBC, and its predictive value is significantly better than PLR. Key words: Neutrophil lymphocyte ratio; Platelet lymphocyte ratio; Invasive bladder cancer; Progression