Validation of pretreatment neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma.
OBJECTIVE
To investigate the potential prognostic significance of the neutrophil-lymphocyte ratio (NLR) in a large European cohort of patients with upper urinary tract urothelial cell carcinoma (UUT-UCC).


METHODS
We retrospectively evaluated data from 202 consecutive patients with non-metastatic upper urinary tract urothelial cell carcinoma (UUT-UCC), who underwent surgery between 1990 and 2012 at a single tertiary academic centre. Patients' cancer-specific survival (CSS) and overall survival (OS) were assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of the NLR, multivariate proportional Cox regression models were applied for both endpoints.


RESULTS
A higher NLR was significantly associated with shorter CSS (P = 0.002, log-rank test), as well as with shorter OS (P < 0.001, log-rank test). Multivariate analysis identified a high NLR as an independent prognostic factor for patients' CSS (hazard ratio 2.72, 95% CI 1.25-5.93, P = 0.012), and OS (hazard ratio 2.48, 95% CI 1.31-4.70, P = 0.005).


CONCLUSIONS
In the present cohort, patients with a high preoperative NLR had higher cancer-specific and overall mortality after radical surgery for UUT-UCC, compared with those with a low preoperative NLR. This easily identifiable laboratory measure should be considered as an additional prognostic factor in UUT-UCC in future.
Department of Urology, Medical University of Graz, Graz, Austria.
Orietta
O
Dalpiaz
Georg C
GC
Ehrlich
Sebastian
S
Mannweiler
Jessica M Martín
JM
Hernández
Armin
A
Gerger
Tatjana
T
Stojakovic
Karl
K
Pummer
Richard
R
Zigeuner
Martin
M
Pichler
Georg C
GC
Hutterer
D014408:Biomarkers, Tumor / Q000276:immunology; D002295:Carcinoma, Transitional Cell / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000473:pathology; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D009504:Neutrophils / Q000276:immunology*; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D019459:Urothelium / Q000473:pathology*
D014408:Biomarkers, Tumor
neutrophil-lymphocyte ratio; prognosis; upper tract urothelial carcinoma