title: Prognostic impact of perioperative lymphocyte-monocyte ratio in patients with bladder cancer undergoing radical cystectomy.
abstract: Various systemic inflammatory response biomarkers are associated with oncological outcome. We evaluated the superiority of prognostic predictive accuracy between neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR), and the prognostic significance of their perioperative change in patients with bladder cancer undergoing radical cystectomy (RC). We retrospectively analyzed 302 patients who had undergone RC in four institutions. Comparison of predictive accuracy between NLR and LMR was performed using receiver operating characteristic curve analysis. Overall survival (OS) and cancer-specific survival (CSS) were assessed with the Kaplan-Meier method and Cox regression analysis. Preoperative and postoperative LMR showed higher predictive accuracy for OS than NLR did (p = 0.034). Applying a cutoff of 3.41, change in perioperative LMR stratified patients into three groups (low, intermediate, and high risk), showing a significant difference in OS and CSS (p < 0.001, each), and pathological outcomes. Multivariable analyses for OS and CSS showed that poor changes in LMR (high risk) were an independent prognostic factor (hazard ratio 5.70, 95 % confidence interval 3.49-9.32, p < 0.001; hazard ratio 4.53, 95 % confidence interval 2.63-7.82, p < 0.001; respectively). Perioperative LMR is significantly associated with survival in patients with bladder cancer after RC, and it is possibly superior to NLR as a prognostic factor.
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan. kinoshih@hirakata.kmu.ac.jp.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kinoshita
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Mishima
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yanishi
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Inui
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Komai
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Motohiko
authors.initials: M
authors.lastname: Sugi
authors.affiliation: Department of Urology and Andrology, Takii Hospital, Kansai Medical University, Hirakata, Osaka, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Urology and Andrology, Takii Hospital, Kansai Medical University, Hirakata, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murota
authors.affiliation: Department of Urology and Andrology, Kori Hospital, Kansai Medical University, Hirakata, Osaka, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Fukui
authors.affiliation: Department of Urology, Saiseikai Noe Hospital, Osaka, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Harada
authors.affiliation: Department of Urology, Saiseikai Noe Hospital, Osaka, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Kawa
authors.affiliation: Department of Urology and Andrology, Hirakata Hospital, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D003131:Combined Modality Therapy; D015653:Cystectomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008197:Lymph Node Excision; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D059035:Perioperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents
keywords: Bladder cancer; Lymphocyte–monocyte ratio; Neutrophil–lymphocyte ratio; Perioperative change; Prognosis; Radical cystectomy
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