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The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

Authors
  • Mártha, Orsolya1
  • Balan, Daniel1
  • Porav-Hodade, Daniel1
  • Drágus, Emőke1
  • Vartolomei, Mihai Dorin1
  • Chibelean, Călin Bogdan1
  • Borda, Angela1
  • Pytel, Ákos2
  • Vida, Olivér Árpád1
  • 1 George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Romania , (Romania)
  • 2 University of Pécs, Hungary , (Hungary)
Type
Published Article
Journal
Revista Romana de Medicina de Laborator
Publisher
De Gruyter Open Sp. z o.o.
Publication Date
Jan 01, 2020
Volume
28
Issue
1
Pages
29–38
Identifiers
DOI: 10.2478/rrlm-2020-0001
Source
De Gruyter
Keywords
License
Green

Abstract

Introduction: The peritumoral inflammatory reaction has a substantial importance in the oncologic outcome of bladder cancer (BC). One biomarker proven to be practical and accessible is the NLR (neutrophil-to-lymphocyte ratio) for high risk non-muscle invasive bladder cancer (NMIBC). The aim of the study was to investigate the role of NLR as a prognostic biomarker for disease recurrence, progression and survival of p Ta (pathological assesment of the primary tumor) NMIBC. Material and Methods: In our retrospective study we included 54 patients with pTa NMIBC from a total of 235 patients who underwent transurethral resection of bladder tumor (TURBT) during two consecutive years: January 2007 - December 2008 [median follow-up 106 months (interquartile range-IQR 68-116)]. Criteria for inclusion were: primary tumor, low-grade, with NLR available at 2 weeks prior to TURBT. NLR was considered altered if higher than 3. Results: The median age of the patients included was 63 years (IQR 55 - 72). Most of the patients had NLR---lt---3 (37 patients). Median EORTC (European Organization of Research and Treatment of Cancer) Recurrence Score was 4 (IQR 1-6), while EORTC Progression Score was 3 (IQR 0-6), respectively. Recurrence occurred in 8 out of 54 (14.81 %) patients and progression was identified in 2 out of 54 (3.70 %) patients with muscle-invasive BC during follow-up. NLR---gt---3 was not associated with clinical and pathological factors. In multivariable Cox regression analyses NLR as a continuous variable was an independent predictive factor for recurrence. Recurrence-free survival (RFS) Kaplan-Meier analysis did not show a statistical significance between NLR groups: 82.67% vs. 64.12%, p=0.26. Kaplan-Meier analysis showed a lower Progression-free survival (PFS) in the NLR---gt---3 group: 94.12% vs. 100%, p=0.04. During follow-up (106 months) 18 patients deceased with no impact of NLR as a prognostic factor in multivariable analyses. Kaplan-Meier overall survival (OS) analysis showed a 10-year OS of 70.27% in the low NLR group compared with 58.82% in the high NLR group, p=0.45. Conclusion: In this cohort, high NLR was associated with high recurrence rate in patients with Ta NMIBC. In low-risk NMIBC NLR could represent a valid biomarker for clinical usage regarding the intensity of follow-up schedule.

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