title: The prognostic significance of preoperative leukocytosis and neutrophil-to-lymphocyte ratio in patients who underwent radical cystectomy for bladder cancer.
abstract: BACKGROUND
  We evaluated the prognostic effects of hematologic parameters of preoperative leukocytosis and neutrophil-to-lymphocyte ratio (NLR) in patients who underwent radical cystectomy for bladder cancer.
  
  
  METHODS
  We retrospectively reviewed the medical records of 363 patients who underwent radical cystectomy for bladder cancer between January 1990 and June 2013. In total, 286 patients were included in the study. Age, gender, pathologic stage, lymph node involvement, preoperative hydronephrosis, histologic sub-type, surgical margin status, and lymphovascular invasion were recorded for each patient. Univariate and multivariate analysis were performed to determine the prognostic value of the preoperative clinical and laboratory parameters on disease-specific survival (DSS). Additionally, the correlation between leukocytosis and other factors were evaluated.
  
  
  RESULTS
  According to the univariate analysis preoperative leukocytosis and NLR were detected as negative prognostic factors on DSS. Preoperative leukocytosis, NLR, stage, lymph node involvement, histologic subtype, grade and age were independent prognostic factors for DSS, on multivariate analysis. Patients with leukocytosis had higher stage, grade and lymphovascular invasion.
  
  
  CONCLUSIONS
  Inexpensive, reproducible, and readily available peripheral blood count components of white blood cell count and NLR were independent prognostic factors, which can stratify DSS risks in bladder cancer patients who underwent radical cystectomy.
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Cihat
authors.initials: C
authors.lastname: Ozcan
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Onur
authors.initials: O
authors.lastname: Telli
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Erdem
authors.initials: E
authors.lastname: Ozturk
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Evren
authors.initials: E
authors.lastname: Suer
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Mehmet Ilker
authors.initials: MI
authors.lastname: Gokce
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Omer
authors.initials: O
authors.lastname: Gulpinar
authors.affiliation: Ankara University, School of Medicine, Department of Biostatistics, Ankara, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Oztuna
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Sumer
authors.initials: S
authors.lastname: Baltaci
authors.affiliation: Ankara University, School of Medicine, Department of Urology, Ankara, Turkey;
authors.forename: Cagatay
authors.initials: C
authors.lastname: Gogus