TY - JOUR
T1 - Prognostic role of pretreatment neutrophil-to-lymphocyte ratio (NLR) in patients with non–muscle-invasive bladder cancer (NMIBC)
T2 - A systematic review and meta-analysis
AU - Vartolomei, Mihai Dorin
AU - Porav-Hodade, Daniel
AU - Ferro, Matteo
AU - Mathieu, Romain
AU - Abufaraj, Mohammad
AU - Foerster, Beat
AU - Kimura, Shoji
AU - Shariat, Shahrokh F.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Objective: The aim of this study was to summarize and analyze the current evidence regarding the prognostic and predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients undergoing transurethral resection of bladder tumors (TURBT) for non–muscle-invasive bladder cancer (NMIBC). Material and methods: A systematic search of Web of Science, Medline/PubMed, Google Scholar, and Cochrane library was performed on the 1st of March, 2018. Studies were deemed eligible if they compared NMIBC patients with high vs. low NLR before TURBT to determine its value for prognosticating disease recurrence and progression using multivariable analysis. We performed a formal meta-analysis for both recurrence-free (RFS) and progression-free survival (PFS). Results: Six studies encompassing 2,298 patients (477 [20.7%] females) assessed the prognostic value of NLR in NMIBC patients treated with TURBT. NLR predicted worse RFS (pooled HR = 1.78; 95% CI: 1.32–2.4, P<0.001) and PFS (pooled HR = 2.14; 95% CI: 1.59–2.87, P<0.001). In 4 studies encompassing 599 patients, high pretreatment NLR was associated with decreased RFS (pooled HR = 2.31; 95% CI: 1.27–4.22, P = 0.006) and in 3 of them high pretreatment NLR was associated with decreased PFS (pooled HR = 2.54; 95% CI: 1.36–4.71, P = 0.003) in high-risk NMIBC patients treated with BCG. Conclusion: In this meta-analysis, peripheral blood levels of NLR were associated with an increased risk of disease recurrence and progression in patients who underwent TURBT for NMIBC. Furthermore, NLR was an independent predictor of disease recurrence and progression in NMIBC treated with BCG patients. NLR could be used to improve clinical decision-making regarding treatment and follow-up scheduling.
AB - Objective: The aim of this study was to summarize and analyze the current evidence regarding the prognostic and predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients undergoing transurethral resection of bladder tumors (TURBT) for non–muscle-invasive bladder cancer (NMIBC). Material and methods: A systematic search of Web of Science, Medline/PubMed, Google Scholar, and Cochrane library was performed on the 1st of March, 2018. Studies were deemed eligible if they compared NMIBC patients with high vs. low NLR before TURBT to determine its value for prognosticating disease recurrence and progression using multivariable analysis. We performed a formal meta-analysis for both recurrence-free (RFS) and progression-free survival (PFS). Results: Six studies encompassing 2,298 patients (477 [20.7%] females) assessed the prognostic value of NLR in NMIBC patients treated with TURBT. NLR predicted worse RFS (pooled HR = 1.78; 95% CI: 1.32–2.4, P<0.001) and PFS (pooled HR = 2.14; 95% CI: 1.59–2.87, P<0.001). In 4 studies encompassing 599 patients, high pretreatment NLR was associated with decreased RFS (pooled HR = 2.31; 95% CI: 1.27–4.22, P = 0.006) and in 3 of them high pretreatment NLR was associated with decreased PFS (pooled HR = 2.54; 95% CI: 1.36–4.71, P = 0.003) in high-risk NMIBC patients treated with BCG. Conclusion: In this meta-analysis, peripheral blood levels of NLR were associated with an increased risk of disease recurrence and progression in patients who underwent TURBT for NMIBC. Furthermore, NLR was an independent predictor of disease recurrence and progression in NMIBC treated with BCG patients. NLR could be used to improve clinical decision-making regarding treatment and follow-up scheduling.
KW - Biomarker
KW - Neutrophil-to-lymphocyte ratio
KW - Non-muscle invasive bladder cancer
KW - Progression
KW - Recurrence
UR - http://www.scopus.com/inward/record.url?scp=85048518992&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048518992&partnerID=8YFLogxK
U2 - 10.1016/j.urolonc.2018.05.014
DO - 10.1016/j.urolonc.2018.05.014
M3 - Review article
C2 - 29884342
AN - SCOPUS:85048518992
VL - 36
SP - 389
EP - 399
JO - Urologic Oncology
JF - Urologic Oncology
SN - 1078-1439
IS - 9
ER -