RRML - Easily Available Blood Test Neutrophil-To-Lymphocyte Ratio Predicts Progression in High-Risk Non-Muscle Invasive Bladder Cancer
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Nr. 25(2)/2017 DOI:10.1515/rrlm-2017-0016
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Easily Available Blood Test Neutrophil-To-Lymphocyte Ratio Predicts Progression in High-Risk Non-Muscle Invasive Bladder Cancer

Orsolya Martha, Daniel Porav-Hodade, Daniel Bălan, Octavian Sabin Tătaru, Anca Sin, Călin Bogdan Chibelean, Mihai Dorin Vartolomei

Correspondence should be addressed to: Porav-Hodade Daniel

Abstract:

Introduction: The inflammatory response surrounding the tumour has a major importance in the oncologic outcome of bladder cancers. One marker proved to be useful and accessible is NLR (neutrophil-to-lymphocyte ratio). The objective of the study was the analysis of NLR as a prognostic factor for recurrence and progression in pT1a and pT1b bladder cancers. Material and Methods: Retrospective study, with 44 T1a/T1b bladder cancer patients. Each patient underwent transurethral resection. NLR was considered altered if higher than 3, average follow-up period was of 18 months. Results: The mean age of the patients included was 73 years (IQR 64 - 77). Most of the patients had NLR<3 (30 patients). In total 29/44 (65.9 %) patients presented recurrence and 15/44 (34.1 %) patients were identified with T2 or higher stage progression during the follow-up period (average 18 months).We found no statistically significant association between NLR>3 and other clinic and pathologic factors. Progression-free survival (PFS) Kaplan-Meier analysis showed a lower PFS in the NLR>3 group, with a p=0.001 value. A total of 64.3% of patients had shown progression in the NLR>3 group and 20% in the NLR<3 group. Mean NLR was 2.67 (IQR 1.88-3.5); 2.50 (IQR 1.89-2.87) in patients that did not present any progression during the follow-up and 3.20 (IQR 1.73-5.80) in those with progression (p=0.09), ROC 0.655. Mean NLR was 2.14 (IQR 1.61-2.77) in patients that did not experience a recurrence during the follow-up and 2.76 (IQR 2.1-4.31) in those with recurrence, ROC 0.671 (p=0.06). Multivariable Cox regression analyses showed that stage T1b and NLR represent independent prognostic factors for PFS. Conclusion: High Neutrophil-to-Lymphocyte ratio retained a statistically significant value, as an independent prognostic factor for bad prognosis of T1 bladder tumors. NLR represents a biomarker that could support a clinical decision making in case of high-risk on-muscle invasive bladder cancer.

Keywords: neutrophil-to-lymphocytes ratio, prognostic factors, bladder cancer, microinvasive

Received: 30.12.2016
Accepted: 7.4.2017
Published: 12.4.2017

 
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How to cite
Martha O, Porav-Hodade D, Bălan D, Tătaru OS, Sin A, Chibelean CB, et al. Easily Available Blood Test Neutrophil-To-Lymphocyte Ratio Predicts Progression in High-Risk Non-Muscle Invasive Bladder Cancer. Rev Romana Med Lab. 2017;25(2):181-9. DOI:10.1515/rrlm-2017-0016