title: Pretreatment lymphocyte-monocyte ratio as a potential prognostic factor in a cohort of patients with upper tract urothelial carcinoma.
abstract: OBJECTIVE
  To investigate the potential prognostic impact of the lymphocyte-monocyte ratio (LMR) in a large European cohort of patients with localised upper urinary tract urothelial carcinoma (UTUC). The LMR as an indicator of systemic inflammatory response has been shown to represent a potential prognostic factor in various types of human cancers. Up to date, the prognostic significance of the LMR in UTUC has not been evaluated.
  
  
  METHODS
  Clinico-pathological data from 182 non-metastatic patients with UTUC, operated between 1990 and 2012 at a single tertiary academic centre, were evaluated retrospectively. Pretreatment LMR was assessed 1 day before surgery. Patients were categorised using an LMR cut-off value of 2.0 according to a calculation by receiver-operating curve analysis. Patients' overall survival (OS) was assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of the LMR, a multivariate proportional Cox regression model was applied for OS.
  
  
  RESULTS
  In multivariate analyses, age on the date of surgery (<65 vs ≥65 years, HR=2.10, 95% CI 1.22 to 3.64), pathological T-stage (pT1 vs pT2-4, HR=2.15, 95% CI 1.26 to 3.67), as well as the LMR (<2 vs ≥2, HR=0.56, 95% CI 0.35 to 0.92) were independent predictors of OS of patients with UTUC.
  
  
  CONCLUSIONS
  In the cohort studied, patients with an elevated (≥2) preoperative LMR had a subsequently longer OS after radical surgery for UTUC, compared with those with a low (<2) preoperative LMR. Thus, we believe this parameter might be considered an additional prognostic factor in UTUC in the future.
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: Georg C
authors: GC
authors: Hutterer
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: N
authors: N
authors: Sobolev
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: Georg C
authors: GC
authors: Ehrlich
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: Thomas
authors: T
authors: Gutschi
authors: Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
authors: Tatjana
authors: T
authors: Stojakovic
authors: Institute of Pathology, Medical University of Graz, Graz, Austria.
authors: Sebastian
authors: S
authors: Mannweiler
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: Karl
authors: K
authors: Pummer
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: Richard
authors: R
authors: Zigeuner
authors: Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors: Martin
authors: M
authors: Pichler
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: Orietta
authors: O
authors: Dalpiaz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001317:Austria; D002277:Carcinoma / Q000097:blood* / Q000473:pathology / Q000628:therapy; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D019459:Urothelium / Q000473:pathology*
keywords: DIAGNOSIS; STATISTICS; URINARY TRACT TUMOURS; UROGENITAL PATHOLOGY