A PROSPECTIVE STUDY OF PRE-TREATMENT NEUTROPHIL-TO-LYMPHOCYTE RATIO PROGNOSTICATE POOR SURVIVAL OUTCOMES AND ADVANCED TUMOR STAGING IN PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER IN A TERTIARY CARE CENTER.

Background:We aim to determine the prognostic value of neutrophil-to-lymphocyte ratio (NLR) in patients undergoingradical cystectomy for UCB,in particularly looking at the disease specific survival and overall survival.This will allow usto better identify more suitable candidates for RC or other neoadjuvant or adjuvant therapies.Methods:This is retrospective study that includes 91 patients that underwent RC for UCB between Jan 2006 to Dec 2015.We excluded 39 patients due to incomplete follow up and neoadjuvant chemotherapeutic treatment. All patients hadhistological proven UCB via transurethral resection of bladder tumor (TURBT).All patients had undergone staging scanswith computed tomographies of the thorax,abdomen and pelvis to confirm the extent of disease.All patients underwentRC and bilateral standard pelvic lymphadenectomies and achieve clear margins on final histology. Outcomes werecorded are Median Disease – specific survival and Median overall survivals.Results: The Median Disease – specific survival for patients with NLR ≥ 2.7 was 20.4 months and with NLR < 2.7 was 59.9months.The Median overall survival for patients with NLR ≥ 2.7 was 21.1 months and with NLR < 2.7 was 58.2 months.Conclusions:These results suggested that NLR could be a novel preoperative factor to stratify and identify patients whomight benefit from multimodal therapies in the treatment of UCB.