Value of preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after radical resection of bladder cancer for muscle-invasive bladder cancer

Abstract

Objective To investigate the value of preoperative neutrophil-to-lymphocyte ratio(NLR) as a prognostic predictor after radical resection of bladder cancer for muscle-bladder cancer. Methods Two hundred and fifty-two cases consecutive muscle-invasive bladder cancer patients treated with total excision radical bladder at the Rology Surgery Department of Affiliated Hospital of Weifang Medical College from January 2006 to March 2010 were retrospectively analyzed, and all patients were diagnosed bladder cancer by pathological examination.Based on the cut-off value of 2.7, all the patients were divided into two groups: a low NLR(<2.7, n=142) group and a high NLR(≥2.7, n=110) group.None accepted neoadjuvant therapy. Results The 5-year overall survival rate was 75.2% in patients of the low NLR group and 53% in the high NLR group, the difference was significant(P=0.005). Univariate analysis showed that NLR(P=0.002), tumor size(P=0.035), T stage(P=0.0022), tumor grade(P=0.04), hydronep-hrosis or no(P=0.031), Lymph node metastasis or no(P=0.003) were associated with survival.Cox multivariate analysis revealed that NLR was independent risk factors of prognosis(HR: 2.586; 95%CI: 1.256-2.851; P=0.039). Conclusion Preoperative NLR≥2.7 may be a convenient biomarker to predict patients with a poor prognosis after radical cystectomy for muscle-invasive bladder cancer. Key words: Bladder cancer; Prognosis; Neutrophil; lymphocyte