You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I1 Apr 2018MP26-02 PREOPERATIVE NEUTROPHIL/LYMPHOCYTE RATIO AS A PROGNOSTICATOR IN UPPER TRACT UROTHELIAL CARCINOMA PATIENTS TREATED CONSERVATIVELY: A RETROSPECTIVE EVALUATION Lorenzo Defidio, Mauro De Dominicis, Luca Di Gianfrancesco, Alessandro Calarco, Michele Antonucci, and Anup Patel Lorenzo DefidioLorenzo Defidio More articles by this author , Mauro De DominicisMauro De Dominicis More articles by this author , Luca Di GianfrancescoLuca Di Gianfrancesco More articles by this author , Alessandro CalarcoAlessandro Calarco More articles by this author , Michele AntonucciMichele Antonucci More articles by this author , and Anup PatelAnup Patel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.860AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the potential prognostic value of neutrophil/lymphocyte ratio (NLR) (expression of the involvement of systemic inflammation in neoplastic growth and progression) in patients with upper tract urothelial carcinoma (UTUC) treated conservatively. METHODS We retrospectively evaluated 130 consecutive patients who underwent RIRS (retrograde intra renal surgery) for UTUC. From patient records, the following values (performed preoperatively): white blood cells (WBC), platelet (PLT), neutrophil (N), lymphocyte (L) counts, were retrospectively collected. NLR, was derived by dividing N by L. These data were compared with tumor characteristics: stage (Ta vs. T1), grade (G1 vs. ≥G2), focality (single vs. multiple), site (ureter vs. kidney ± ureter), and size (≤ 1 cm vs. > 1 cm). The endpoints were: recurrence at the first follow-up, multiple recurrences during follow-up, and progression. They were stratified by the NLR cut-off point, according to the receiver operating characteristic analysis. T-test and chi-square test were used to evaluate parametric and non parametric variables. Statistical significance was considered at p < 0,05. RESULTS The average NLR value was 3.48±1.92. Significantly higher NLR values were observed in patients with ≥pT1 (p=0.0001), ≥G2 (p=0.0009), multifocal (p=0.028), >1 cm tumor (p=0.0001). The optimum cut-off value for NLR was 3 for all the endpoints.. Patients with NLR >3, exhibited a risk of recurrence at first follow-up 3 times higher (p=0.007, OR 2.94), a risk of multiple recurrences 1,5 times higher (p=0.006, OR 1.54), and a risk of disease progression 5 times higher (p=0.04, OR 5,00). CONCLUSIONS The preoperative evaluation of NLR provides valuable prognostic information for the selection and clinical management of UTUC patients treated conservatively. These data show that high NLR (>3) was associated with higher recurrence and progression rates. It may identify those needing more frequent endoscopic follow-up with biopsies, and lower thresholds to conversion to more aggressive surgical strategies except in imperative situations. Prospective multicenter studies with larger study populations are needed to validate the role of NLR >3, as a prognosticator of recurrence and progression in patients with UTUC treated conservatively, before incorporation into international practice guidelines. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e335 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Lorenzo Defidio More articles by this author Mauro De Dominicis More articles by this author Luca Di Gianfrancesco More articles by this author Alessandro Calarco More articles by this author Michele Antonucci More articles by this author Anup Patel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...