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Lymphocyte‐to‐monocyte ratio and neutrophil‐to‐lymphocyte ratio as biomarkers for predicting lymph node metastasis and survival in patients treated with radical cystectomy
Author(s) -
D'Andrea David,
Moschini Marco,
Gust Kilian M.,
Abufaraj Mohammad,
Özsoy Mehmet,
Mathieu Romain,
Soria Francesco,
Briganti Alberto,
Rouprêt Morgan,
Karakiewicz Pierre I.,
Shariat Shahrokh F.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24521
Subject(s) - medicine , cystectomy , receiver operating characteristic , lymph node , concordance , lymphocyte , oncology , urology , proportional hazards model , bladder cancer , odds ratio , neutrophil to lymphocyte ratio , logistic regression , lymph , lymph node metastasis , gastroenterology , metastasis , pathology , cancer
PURPOSE To evaluate the role of lymphocyte‐to‐monocyte ratio (LMR) and neutrophil‐to‐lymphocyte ratio (NLR) as pre‐operative markers for predicting extravesical disease and survival outcomes in patients undergoing radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS Data from 4335 patients undergoing RC for clinically non‐metastatic UCB were analyzed. Multivariable logistic regression models were used to predict lymph node involvement and extravesical disease (defined as ≥pT3 and N0). Recurrence‐free (RFS), cancer‐specific (CSS), and overall survival (OS) were evaluated using multivariable Cox models. The accuracy of the models was assessed with receiver operating characteristics (ROC) curves and concordance‐index. RESULTS Median LMR was 3.5 and median NLR was 2.7. Addition of LMR and NLR to a standard preoperative model improved its discrimination for prediction of lymph node metastasis by 4.5%. On multivariable analysis LMR and NLR independently predicted RFS, CSS, and OS. The discrimination of this model increased by adding LMR and NLR but was not significant. CONCLUSIONS LMR and NLR independently improved the preoperative prediction of lymph node metastasis and survival outcomes. As they are readily available, they could be integrated in a panel of preoperative markers helping selecting patients who have extravesical lymph node involvement and more aggressive disease.