Subclassification of upper urinary tract urothelial carcinoma by the neutrophil-to-lymphocyte ratio (NLR) improves prediction of oncological outcome
Article first published online: 14 MAR 2014
© 2013 The Authors. BJU International © 2013 BJU International
Special Issue: Focus on Urological Oncology
Volume 113, Issue 5b, pages E144–E149, May 2014
How to Cite
Luo, H.-L., Chen, Y.-T., Chuang, Y.-C., Cheng, Y.-T., Lee, W.-C., Kang, C.-H. and Chiang, P.-H. (2014), Subclassification of upper urinary tract urothelial carcinoma by the neutrophil-to-lymphocyte ratio (NLR) improves prediction of oncological outcome. BJU International, 113: E144–E149. doi: 10.1111/bju.12582
- Issue published online: 23 APR 2014
- Article first published online: 14 MAR 2014
- Accepted manuscript online: 26 NOV 2013 05:50AM EST
- neutrophil to lymphocyte;
- upper urinary tract;
- urothelial carcinoma
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.
Only advanced pathological stage (>T2) 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 T3 UUT-UC for metastasis-free survival and cancer-specific survival (log-rank test, both P < 0.001).
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 T3 UUT-UC seems to further identify a poor prognostic group and may help with clinical decisions about treatment intervention in clinical practice.