Does neutrophil-lymphocyte ratio show recurrence in patients who underwent curative resection for non-muscle-invasive bladder cancer?

Abstract

Aim: The role of inflammation is a critical component of tumor progression and the neutrophil-lymphocyte ratio (NLR) reflects inflammatory status. We aimed to determine the clinical significance of the preoperative NLR in patients with non-muscle-invasive bladder cancer (NMIBC). 

Methods: A total of 178 patients, who underwent curative transurethral resection of bladder tumor (TURBT) for NMIBC between 2011 and 2016 in the urology department of Pamukkale University and Uludağ University were included in the study. Data including clinical characteristics, surgery, pathology, and follow-up were obtained from a retrospectively maintained database. Patients were divided into groups according to pre-operative NLR values (h-NLR group: ≥2.5, l-NLR group: NLR <2.5). Their cut-off values were determined through receiver operation characteristics curves analysis. Recurrence rates of the patients were determined in the 1st year follow-up. For further analysis, all of the patients were allocated according to their risk ratio according to European Organization for Research and Treatment of Cancer (EORTC) tables as low, intermediate and high, and all of the groups have been evaluated according to the risk ratio. 

Results: NLR patients (55.6% of the cases) were associated with worse risk of bladder cancer recurrence as compared to l-NLR group (P=0.005). Kaplan-Meier plots illustrated that higher pre-operative NLR had decreased disease-free survival (DFS). Low pre-operative PLR and NLR levels correlated with recurrence. 

Conclusion: The present research shows that NLR is a prognostic indicator in NMIBC. Calculating NLR value might be useful at predicting recurrence in NMIBC patients.

Keywords

• Bladder cancer,Recurrence,Neutrophil-lymphocyte ratio

Nötrofil lenfosit oranı, küratif rezeksiyon ile tedavi edilen yüzeyel mesane kanserinde rekürrensi gösterir mi?

Öz

Amaç: Enflamasyon, tümörün ilerlemesinin kritik bir bileşenidir ve nötrofil lenfosit oranı (NLR), enflamasyonun bir göstergesidir. Bu araştırmanın amacı; NLR'nin yüzeyel mesane kanserinde (NMIBC) prognostik bir gösterge olup olmadığını göstermekdir. 

Yöntemler: Pamukkale ve Uludağ Üniversitesi Üroloji Anabilim Dalları'nda 2011-2016 yılları arasında yüzeyel mesane kanseri nedeni ile, sadece küratif amaçlı transüretral mesane rezeksiyonu uygulanan (TUR-M) toplam 178 hasta çalışmaya dahil edildi. Hastaların klinik ve patolojik verileri retrospektif olarak incelendi. Ameliyat öncesi nötrofil/lenfosit oranına (NLR) göre NLR ≥2.5 (h-NLR) ve <2.5 (l-NLR) olacak şekilde iki gruba ayrıldı. Ayrıca hastalar daha ileri analiz için, Avrupa Üroloji Derneği risk sınıflamasına göre düşük, orta ve yüksek riskli mesane tümörü olarak alt gruplara bölündü ve kendi içinde ayrıca değerlendirildi. 1. Yıl sonunda nüks oranları belirlendi ve rekürrens oranlarına göre istatiksel analiz uygulandı. NLR 2,5 cut-off değerine göre toplam hastalıksız geçen süre Kaplan Meier eğrisi kullanılarak analiz edildi. 

Bulgular: Yapılan değerlendirmeler ile h-NLR hastaları (%55,6), l-NLR hastalarına göre istatiksel anlamlı olarak yüksek rekürrens oranlarına sahipti (P=0.005). Kaplan-Meier analizi sonucunda, h-NLR'nin hastalıksız geçen süreyi önemli ölçüde azalttığını ve rekürrensi arttırdığını göstermiştir. 

Sonuç: NLR'nin, NMIBC hastalarında tümör rekürrensi değerlendirmesinde kullanılabilecek, faydalı bir biyobelirteç gibi görünmektedir.

Anahtar Kelimeler

• Mesane kanseri,Rekürrens,Nötrofil-lenfosit oranı

Kaynakça

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