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Subclassification of upper urinary tract urothelial carcinoma by the neutrophil‐to‐lymphocyte ratio ( NLR ) improves prediction of oncological outcome
Author(s) -
Luo HaoLun,
Chen YenTa,
Chuang YaoChi,
Cheng YuanTso,
Lee WeiChing,
Kang ChihHsiung,
Chiang PoHui
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12582
Subject(s) - medicine , neutrophil to lymphocyte ratio , upper urinary tract , stage (stratigraphy) , pathological , metastasis , oncology , urology , cancer , t stage , gastroenterology , urinary system , urothelial carcinoma , carcinoma , lymphocyte , bladder cancer , paleontology , biology
Objective To examine the potential role of the neutrophil‐to‐lymphocyte ratio ( NLR ) for subclassification of localised upper urinary tract urothelial carcinoma ( UUT‐UC ). Patients and Methods From 2004 to 2010, 234 patients with localised UUT‐UC underwent radical nephroureterectomy ( RNU ). NLRs were only obtained under afebrile conditions before RNU . Patients that underwent neoadjuvant or adjuvant chemotherapy were excluded. The prognostic impact of the NLR was assessed using the log‐rank test and multivariate analyses. Results Only advanced pathological stage (> T 2) and a NLR of >3 were independently associated with metastasis ( P < 0.001 and P = 0.02, respectively) and cancer‐specific mortality ( P = 0.002 and P = 0.006, respectively). The use of a NLR of >3 further identified a poor prognostic group, especially in patients with T 3 UUT‐UC for metastasis‐free survival and cancer‐specific survival (log‐rank test, both P < 0.001). Conclusions For localised UUT‐UC , pathological stage and preoperative NLR independently predict systemic recurrence and cancer‐specific death after RNU . Using the NLR for subclassification of T 3 UUT‐UC seems to further identify a poor prognostic group and may help with clinical decisions about treatment intervention in clinical practice.