Validation of Neutrophil-to-lymphocyte Ratio in a Multi-institutional Cohort of Patients With T1G3 Non–muscle-invasive Bladder Cancer

Mihai Dorin Vartolomei, Matteo Ferro, Francesco Cantiello, Giuseppe Lucarelli, Savino Di Stasi, Rodolfo Hurle, Giorgio Guazzoni, Gian Maria Busetto, Ettore De Berardinis, Rocco Damiano, Sisto Perdona, Paolo Verze, Roberto La Rocca, Marco Borghesi, Riccardo Schiavina, Eugenio Brunocilla, Gilberto L. Almeida, Pierluigi Bove, Estevao Lima, Giovanni GrimaldiRiccardo Autorino, Nicolae Crisan, Abdal Rahman Abu Farhan, Michele Battaglia, Vincenzo Serretta, Giorgio Ivan Russo, Giuseppe Morgia, Daniela Terracciano, Gennaro Musi, Ottavio de Cobelli, Vincenzo Mirone, Shahrokh F. Shariat

Research output: Contribution to journalArticle

Abstract

Neutrophil-to-lymphocyte ratio was found associated with worse disease recurrence and progression in patients with T1 non–muscle-invasive bladder cancer in some single-center studies. We validated high pretreatment neutrophil-to-lymphocyte ratio (cutoff, 3) as an independent predictor of disease recurrence, progression, and cancer-specific survival in patients with primary T1 HG/G3 non–muscle-invasive bladder cancer treated with intravesical bacillus Calmette-Guérin therapy. Introduction: The aim of this multicenter study was to investigate the prognostic role of neutrophil-to-lymphocyte ratio (NLR) and to validate the NLR cutoff of 3 in a large multi-institutional cohort of patients with primary T1 HG/G3 non–muscle-invasive bladder cancer (NMIBC). Patients and Methods: The study period was from January 2002 through December 2012. A total of 1046 patients with primary T1 HG/G3 who had NMIBC on re-transurethral bladder resection (TURB) who received adjuvant intravesical bacillus Calmette-Guérin therapy with maintenance from 13 academic institutions were included. Endpoints were time to disease, and recurrence-free (RFS), progression-free (PFS), overall (OS), and cancer-specific survival (CSS). Results: A total of 512 (48.9%) of patients had NLR ≥ 3 prior to TURB. High pretreatment NLR was associated with female gender and residual T1HG/G3 on re-TURB. The 5-year RFS estimates were 9.4% (95% confidence interval [CI], 6.8%-12.4%) in patients with NLR ≥ 3 compared with 58.8% (95% CI, 54%-63.2%) in patients with NLR <3; the 5-year PFS estimates were 57.1% (95% CI, 51.5%-62.2%) versus 79.2% (95% CI, 74.7%-83%; P
Original languageEnglish
JournalClinical Genitourinary Cancer
DOIs
Publication statusPublished - 2018

Keywords

  • High risk
  • High-grade
  • NLR
  • Progression
  • Recurrence

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    Vartolomei, M. D., Ferro, M., Cantiello, F., Lucarelli, G., Di Stasi, S., Hurle, R., Guazzoni, G., Busetto, G. M., De Berardinis, E., Damiano, R., Perdona, S., Verze, P., La Rocca, R., Borghesi, M., Schiavina, R., Brunocilla, E., Almeida, G. L., Bove, P., Lima, E., ... Shariat, S. F. (2018). Validation of Neutrophil-to-lymphocyte Ratio in a Multi-institutional Cohort of Patients With T1G3 Non–muscle-invasive Bladder Cancer. Clinical Genitourinary Cancer. https://doi.org/10.1016/j.clgc.2018.07.003