title: Prognostic value of systemic inflammatory responses in patients with upper urinary tract urothelial carcinoma.
abstract: OBJECTIVE
  To determine the utility of systemic inflammatory response and develop a model based on serum inflammatory indices to aid prognostication in patients with upper urinary tract urothelial carcinoma (UTUC).
  
  
  METHODS
  The study population comprised 277 patients with non-metastatic UTUC who underwent nephroureterectomy between 1999 and 2010. Multivariate survival analysis was performed using Cox's proportional hazards model, and a new model was developed to predict recurrence-free (RFS) and disease-specific survival (DSS). The factors considered, in relation to systemic inflammatory responses, were as follows: albumin, white blood cell count, neutrophil count, lymphocyte count, red blood cell count, serum creatinine level, platelet count, prognostic nutritional index, platelet/lymphocyte ratio, neutrophil/lymphocyte ratio (NLR), and derived NLR.
  
  
  RESULTS
  The final model consisted of bladder cuffing, pathologic T stage, lymphovascular invasion, and derived NLR. The bootstrap-concordance indices of the model were 0.778 [95 confidence interval (CI) 0.730-0.826] for RFS and 0.802 (95 % CI 0.752-0.851) for DSS, respectively, and integrated area under the curve value for time to RFS and DSS for patients was 0.738 and 0.760, respectively. When we generated calibration curves, the nomograms were reasonably calibrated.
  
  
  CONCLUSIONS
  Derived NLR may be used in combination with conventional staging techniques and other clinicopathological parameters to improve the prediction of survival in patients with UTUC.
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Myong
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Kyung Chul
authors.initials: KC
authors.lastname: Moon
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Choi
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Jeong
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Cheol
authors.initials: C
authors.lastname: Kwak
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Hyeon Hoe
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Seoul, South Korea. kuuro70@snu.ac.kr.|Department of Urology, Seoul National University Hospital, 101 Daehak-ro, Jongno-Gu, Seoul, 110-744, South Korea. kuuro70@snu.ac.kr.
authors.forename: Ja Hyeon
authors.initials: JH
authors.lastname: Ku
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000473:pathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014571:Urologic Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology*
keywords: Inflammation; Nephroureterectomy; Prognosis; Survival; Ureter; Urothelial carcinoma