title: [Clinical impact of peripheral lymphocyte counts for metastatic urothelial carcinoma patients treated with chemotherapy].
abstract: Pre-chemotherapeutic factors to assess the prognosis of patients with advanced urothelial carcinoma have not yet been completely established. The immune response of the host to the tumor is lymphocyte dependent. However, the effect of lymphocytes on chemotherapy prognosis is unknown. In this study, we investigated the correlation between pre-chemotherapeutic lymphocyte counts and the clinical characteristics of urothelial carcinoma and determined the effectiveness of lymphocytes as a prognostic predictor for metastatic urothelial carcinoma treated with chemotherapy. Between April 2003 and March 2011, data from 34 patients with unresectable or metastatic urothelial carcinoma were retrospectively subjected to multivariate regression analysis to determine the patient characteristics with independent prognostic significance for survival. The median patient age was 71 ; 21 patients were male and 13 female. The number of primary tumors in the pelvis, ureter, and bladder were four, six, and 24, respectively. Seventeen patients underwent prior curative resections, and visceral metastases at chemotherapy were detected in 14 patients. The median lymphocyte count at chemotherapy was 1,292/ml. Cancer-specific survival was significantly lower in patients with lymphocyte counts ＜1,000/ml than in patients with lymphocyte counts ≥1,000/μl (p＝0. 001). During multivariate analysis, visceral metastasis and lymphocyte counts were independent factors for predicting poor prognosis. In addition, lymphocyte counts of ＜1, 000/ml or positive visceral metastases also affected survival. This information may be useful for identifying patients who are likely to benefit from chemotherapy.
authors.affiliation: The Department of Urology, Chibaken Saiseikai Narashino Hospital.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sekita
authors.affiliation: The Department of Urology, Graduate School of Medicine, Chiba University.
authors.forename: Rika
authors.initials: R
authors.lastname: Nishikawa
authors.affiliation: The Department of Urology, Chibaken Saiseikai Narashino Hospital.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Fujimura
authors.affiliation: The Department of Urology, Chibaken Saiseikai Narashino Hospital.
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Takeuchi
authors.affiliation: The Division of Pharmacy, Chibaken Saiseikai Narashino Hospital.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ogino
authors.affiliation: The Division of Pharmacy, Chibaken Saiseikai Narashino Hospital.
authors.forename: Naoki
authors.initials: N
authors.lastname: Shibata
authors.affiliation: The Division of Pharmacy, Chibaken Saiseikai Narashino Hospital.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Omura
authors.affiliation: The Department of Urology, Chibaken Saiseikai Narashino Hospital.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Mikami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D014571:Urologic Neoplasms / Q000097:blood* / Q000188:drug therapy*