The prognostic value of preoperative neutrophil-to-lymphocyte ratio in patients with upper tract urothelial carcinoma

Abstract

BackgroundWe evaluated the prognostic impact of the preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy treatment. MethodsA total of 717 patients were identified between 2003 and 2016. The cutoff value of NLR was set as 2.5. Kaplan–Meier method and Cox's proportional hazards regression models were utilized to analyze the association between NLR and oncological outcomes. ResultsThe median follow-up was 42 months. The results suggested that preoperative elevated NLR was associated with worse pathological features. Also, patients with NLR ≥ 2.5 had worse survival outcomes than those with NLR <2.5 (all P < .001). Multivariate cox analysis revealed that NLR ≥ 2.5 was an independent predictor of worse cancer-specific survival, disease recurrence-free survival, metastasis-free survival and overall survival (HR 1.95, 95%CI: 1.42–2.69, P < .001; HR 1.70, 95%CI: 1.31–2.20, P < .001; HR 1.67, 95%CI: 1.22–2.31, P = .002; and HR 1.88, 95%CI: 1.42–2.50, P < .001; respectively). Notably, NLR was ascertained to be a useful prognostic predictor in patients with high-grade disease, but not in those with low-grade UTUC. ConclusionsPreoperative elevated NLR was associated with worse outcomes in patients with UTUC. Subgroup analysis affirmed that NLR was a useful predictor in patients with high-grade disease, but not in those with low-grade UTUC.