Is preoperative neutrophil-lymphocyte ratio important in patients who undergo radical nephroureterectomy for upper urinary tract urothelial cancer?

Is preoperative neutrophil-lymphocyte ratio important in patients who undergo radical nephroureterectomy for upper urinary tract urothelial cancer?

Aim: To evaluate the effect of preoperative blood count parameters and pathological features on recurrence in patients who underwent Radical Nephroureterectomy (RNU) and Bladder Cuff Resection for Upper Urinary Tract Urothelial Cancer (UTUC). Material and Methods: The data of patients who underwent RNU for UTUC were reviewed retrospectively. According to the follow-up data, the patients were divided into 2 groups as recurrence and non-recurrence. It was examined whether there was a difference between the groups in terms of preoperative blood count parameters (neutrophil, lymphocyte, eosinophil, monocytes, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio) and final pathological features. A p < 0.05 was considered statistically significant. Results: A total of 64 patients were included in the study. Recurrence developed in 24 patients during follow-up. Age (p=0.039), neutrophil-lymphocyte ratio (p=0.026), history of bladder cancer (p=0.004), pathological stage (p=0.03), multifocality (p=0.007), positive bladder cuff (p=0.006) and surgical margin positivity (p=0.029) was found to be significantly different in the recurrence group compared to the non-recurrence group. Conclusion: In addition to pathological features, preoperative Neutrophil-Lymphocyte ratio may be associated with recurrence in patients undergoing UTUC and RNU. It should be supported by studies with a larger number of patients

___

  • 1. Soria F, Shariat SF, Lerner SP, Fritsche H-M, Rink M, Kassouf W, et al. Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC). World J Urol. 2017 Mar;35(3):379–87.
  • 2. Rouprêt M, Babjuk M, Compérat E, Zigeuner R, Sylvester RJ, Burger M, et al. European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2017 Update. Eur Urol. 2018 Jan;73(1):111–22.
  • 3. Xylinas E, Rink M, Cha EK, Clozel T, Lee RK, Fajkovic H, et al. Impact of distal ureter management on oncologic outcomes following radical nephroureterectomy for upper tract urothelial carcinoma. Eur Urol. 2014 Jan;65(1):210–7.
  • 4. Soria F, Giordano A, D’Andrea D, Moschini M, Rouprêt M, Margulis V, et al. Prognostic value of the systemic inflammation modified Glasgow prognostic score in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy: Results from a large multicenter international collaboration. Urol Oncol. 2020 Jun;38(6):602.e11- 602.e19.
  • 5. Novara G, Matsumoto K, Kassouf W, Walton TJ, Fritsche H-M, Bastian PJ, et al. Prognostic role of lymphovascular invasion in patients with urothelial carcinoma of the upper urinary tract: an international validation study. Eur Urol. 2010 Jun;57(6):1064– 71.
  • 6. Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E, et al. Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer. 2009 Mar 15;115(6):1224–33.
  • 7. Kohada Y, Hayashi T, Goto K, Kobatake K, Abdi H, Honda Y, et al. Preoperative risk classification using neutrophillymphocyte ratio and hydronephrosis for upper tract urothelial carcinoma. Jpn J Clin Oncol. 2018 Sep 1;48(9):841–50.
  • 8. Altan M, Haberal HB, Akdoğan B, Özen H. A critical prognostic analysis of neutrophil-lymphocyte ratio for patients undergoing nephroureterectomy due to upper urinary tract urothelial carcinoma. Int J Clin Oncol. 2017 Oct;22(5):964–71.
  • 9. Shao Y, Li W, Wang D, Wu B. Prognostic value of preoperative lymphocyte-related systemic inflammatory biomarkers in upper tract urothelial carcinoma patients treated with radical nephroureterectomy: a systematic review and meta-analysis. World J Surg Oncol. 2020 Oct 23;18(1):273.
  • 10. Cimen HI, Halis F, Saglam HS, Gokce A. Can neutrophil to lymphocyte ratio predict lamina propria invasion in patients with non muscle invasive bladder cancer? Int Braz J Urol Off J Braz Soc Urol. 2017 Feb;43(1):67–72.
  • 11. Vartolomei MD, Mathieu R, Margulis V, Karam JA, Rouprêt M, Lucca I, et al. Promising role of preoperative neutrophil-to-lymphocyte ratio in patients treated with radical nephroureterectomy. World J Urol. 2017 Jan;35(1):121–30.
  • 12. Tanaka N, Kikuchi E, Kanao K, Matsumoto K, Shirotake S, Miyazaki Y, et al. A multi-institutional validation of the prognostic value of the neutrophil-to-lymphocyte ratio for upper tract urothelial carcinoma treated with radical nephroureterectomy. Ann Surg Oncol. 2014 Nov;21(12):4041–8.
  • 13. Luo H-L, Chen Y-T, Chuang Y-C, Cheng Y-T, Lee W-C, Kang C-H, et al. Subclassification of upper urinary tract urothelial carcinoma by the neutrophil-to-lymphocyte ratio (NLR) improves prediction of oncological outcome. BJU Int. 2014 May;113(5b):E144-149.
  • 14. Zhao, Z., Xie, S., Feng, B., Zhang, S., Sun, Y., Guo, H., & Yang, R. (2020). Preoperative Risk Classification Using Neutrophil-to-Lymphocyte Ratio and Albumin for Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy. Cancer management and research, 12, 9023–9032. https://doi.org/10.2147/CMAR.S274332
  • 15. De Larco JE, Wuertz BRK, Furcht LT. The potential role of neutrophils in promoting the metastatic phenotype of tumors releasing interleukin-8. Clin Cancer Res Off J Am Assoc Cancer Res. 2004 Aug 1;10(15):4895–900.
  • 16. Kim R, Emi M, Tanabe K. Cancer immunoediting from immune surveillance to immune escape. Immunology. 2007 May;121(1):1– 14.
  • 17. Dalpiaz O, Ehrlich GC, Mannweiler S, Hernández JMM, Gerger A, Stojakovic T, et al. Validation of pretreatment neutrophillymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma. BJU Int. 2014 Sep;114(3):334–9.
  • 18. Jan H-C, Yang W-H, Ou C-H. Combination of the Preoperative Systemic Immune-Inflammation Index and MonocyteLymphocyte Ratio as a Novel Prognostic Factor in Patients with Upper-Tract Urothelial Carcinoma. Ann Surg Oncol. 2019 Feb;26(2):669–84.
  • 19. Zheng Y, Chen Y, Chen J, Chen W, Pan Y, Bao L, et al. Combination of Systemic Inflammation Response Index and Plateletto-Lymphocyte Ratio as a Novel Prognostic Marker of Upper Tract Urothelial Carcinoma After Radical Nephroureterectomy. Front Oncol. 2019;9:914.
  • 20. Son S, Hwang E-C, Jung S-I, Kwon D-D, Choi S-H, Kwon TG, et al. Prognostic value of preoperative systemic inflammation markers in localized upper tract urothelial cell carcinoma: a large, multicenter cohort analysis. Minerva Urol E Nefrol Ital J Urol Nephrol. 2018 Jun;70(3):300–9.
  • 21. Huang J, Yuan Y, Wang Y, Zhang J, Kong W, Chen H, et al. Prognostic value of preoperative plasma fibrinogen level and platelet-to-lymphocyte ratio (F-PLR) in patients with localized upper tract urothelial carcinoma. Oncotarget. 2017 May 30;8(22):36761–71.
  • 22. Song X, Zhang G-M, Ma X-C, Luo L, Li B, Chai D-Y, et al. Comparison of preoperative neutrophil-lymphocyte, lymphocytemonocyte, and platelet-lymphocyte ratios in patients with upper urinary tract urothelial carcinoma undergoing radical nephroureterectomy. OncoTargets Ther. 2016;9:1399–407.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Clinical and radiological results of cemented proximal femoral nails

Mustafa YERLİ, Ali Çağrı TEKİN, Mehmet Kürşad BAYRAKTAR, Hakan GÜRBÜZ, Nazım ERKURT, Tahsin Olgun BAYRAKTAR, Ali YÜCE, Müjdat ADAŞ

Hepatoblastoma: Is it really un-resectable?

Koray ACARLI, Altan ALİM

Investigation of the toxicity of acetamiprid in SH-SY5Y neural cells

İsmail KAYA, Hülya BİRİNCİ, İlker Deniz CİNGÖZ, Mustafa ÖZTATLICI, Suna KARADENİZ SAYGILI

Endovascular treatment of brain arteriovenous malformations: Our clinical experience

Gökhan YÜCE, Adem DOĞAN

Distribution of arrhythmic events in COVID-19 patients receiving favipiravir and hydroxychloroquine

Serhat KARADAVUT, İsmail ALTINTOP

A new marker in inflammatory etiopathogenesis of Bell’s palsy: Immature granulocyte

Sedat GÜLTEN, Ayhan KARS, Fatma ATALAY, Kübra TOPAL

Reverse shoulder arthroplasty: Short to mid-term clinical and radiological results

Emre ERGEN, Mehmet ŞAH ŞAKÇI, Hüseyin Utku ÖZDEŞ, Ersen TÜRKMEN, Kadir ERTEM, Ali CANBAY

Predictive roles of interpeduncular and pontomesencephalic angle measurements, which are anatomical landmarks in cranial MRI, in the differential diagnosis of pediatric headache

Oğuzhan ÖZDEMİR, Muhammet Bora UZUNER, Döndü ÜLKER ÜSTEBAY

Retrospective evaluation of gastrointestinal system infections: Investigation of viral, bacterial, and parasitic etiological agents

Tuğba KULA ATİK, Ali DURAN, Alev ÇETİN DURAN, Diğdem ÖZER YILDIRIM

Prostate gland localization with fiducial markers

Gül KANYILMAZ, Hatice ÖNDER