Clinical Value of Postoperative Neutrophil-to-Lymphocyte Ratio Change As a Detection Marker of Bladder Cancer Recurrence

Overview

Journal Cancer Manag Res

Publisher Dove Medical Press

Specialty Oncology

Date 2021 Feb 5

PMID 33542658

Citations 6

Authors

Qingyun Zhang

Qinqiao Lai

Shan Wang

Qinggui Meng

Zengnan Mo

Affiliations

Soon will be listed here.

Abstract

Purpose: This study investigated the clinical significance of postoperative neutrophil-to-lymphocyte ratio (NLR) changes in bladder cancer recurrence.

Patients And Methods: For evaluating the predictive value of postoperative dynamic change of NLR, a retrospective cohort study was performed to analyze 213 patients with bladder cancer who underwent surgical treatment from January 2013 to December 2019 at the Affiliated Tumor Hospital of Guangxi Medical University. Baseline characteristics and recurrence-free survival (RFS) were statistically compared, and a multivariate analysis was used to identify prognostic factors.

Results: Compared with preoperative NLR levels, postoperative decreased NLR in 130 patients and postoperative increased NLR in 83 patients were detected. The 1-, 3- and 5-year RFS rates were 88.0%, 75.4% and 75.4% in the decreased postoperative NLR group, respectively, and 51.2%, 25.8% and 16.1% in the increased postoperative NLR group, respectively (P < 0.05). Kaplan-Meier curves showed that the cumulative DFS rate in the increased group was significantly lower than that in the decreased group (P < 0.05). The preoperative NLR showed significant difference with postoperative NLR in the total cohort, high-grade non-muscle-invasive bladder cancer (HG-NMIBC) and muscle-invasive bladder cancer (MIBC) group, while there was no significant difference between postoperative NLR and NLR of recurrence or last follow-up. Multivariate analysis suggested that postoperative-preoperative NLR was an independent predictor for RFS (HR=6.206, 95% CI: 3.826-10.067, P < 0.001) in the total cohort, RFS (HR=9.373, 95% CI: 2.724-32.245, P < 0.001) in the LG-NMIBC group, RFS rates (HR=6.873, 95% CI: 2.486-18.999, P < 0.001) in the HG-NMIBC group and RFS rates (HR=6.109, 95% CI: 2.847-13.109, P < 0.001) in the MIBC group.

Conclusion: The dynamic change of postoperative NLR is a potential marker for the early detection of bladder cancer recurrence. Patients with increased NLR after surgery tend to have higher risk of recurrence.

Citing Articles

Matched analysis of detailed peripheral blood and tumor immune microenvironment profiles in bladder cancer.

Chen J, Salas L, Wiencke J, Koestler D, Molinaro A, Andrew A Epigenomics. 2024; 16(1):41-56.

PMID: 38221889 PMC: 10804212. DOI: 10.2217/epi-2023-0358.

Genome-Scale Methylation Analysis Identifies Immune Profiles and Age Acceleration Associations with Bladder Cancer Outcomes.

Chen J, Salas L, Wiencke J, Koestler D, Molinaro A, Andrew A Cancer Epidemiol Biomarkers Prev. 2023; 32(10):1328-1337.

PMID: 37527159 PMC: 10543967. DOI: 10.1158/1055-9965.EPI-23-0331.

The impact of smoking on recurrence and progression of non-muscle invasive bladder cancer: a systematic review and meta-analysis.

Slusarczyk A, Zapala P, Zapala L, Radziszewski P J Cancer Res Clin Oncol. 2022; 149(6):2673-2691.

PMID: 36404390 PMC: 10129946. DOI: 10.1007/s00432-022-04464-6.

Preoperative White Blood Cell-Related Indicators Can Predict the Prognosis of Patients with Transurethral Resection of Bladder Cancer.

Gao M, Yang Q, Xu H, Chen Z, Wang X, Guo H J Inflamm Res. 2022; 15:4139-4147.

PMID: 35903290 PMC: 9317378. DOI: 10.2147/JIR.S373922.

Immune profiles and DNA methylation alterations related with non-muscle-invasive bladder cancer outcomes.

Chen J, Salas L, Wiencke J, Koestler D, Molinaro A, Andrew A Clin Epigenetics. 2022; 14(1):14.

PMID: 35063012 PMC: 8783448. DOI: 10.1186/s13148-022-01234-6.

References

Babjuk M, Bohle A, Burger M, Capoun O, Cohen D, Comperat E . EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2016; 71(3):447-461. DOI: 10.1016/j.eururo.2016.05.041. View

Lee S, Russell A, Hellawell G . Predictive value of pretreatment inflammation-based prognostic scores (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio) for invasive bladder carcinoma. Korean J Urol. 2015; 56(11):749-55. PMC: 4643170. DOI: 10.4111/kju.2015.56.11.749. View

Orditura M, Galizia G, Diana A, Saccone C, Cobellis L, Ventriglia J . Neutrophil to lymphocyte ratio (NLR) for prediction of distant metastasis-free survival (DMFS) in early breast cancer: a propensity score-matched analysis. ESMO Open. 2016; 1(2):e000038. PMC: 5070254. DOI: 10.1136/esmoopen-2016-000038. View

Mano R, Baniel J, Shoshany O, Margel D, Bar-On T, Nativ O . Neutrophil-to-lymphocyte ratio predicts progression and recurrence of non-muscle-invasive bladder cancer. Urol Oncol. 2014; 33(2):67.e1-7. DOI: 10.1016/j.urolonc.2014.06.010. View

Vartolomei M, Ferro M, Cantiello F, Lucarelli G, Di Stasi S, Hurle R . Validation of Neutrophil-to-lymphocyte Ratio in a Multi-institutional Cohort of Patients With T1G3 Non-muscle-invasive Bladder Cancer. Clin Genitourin Cancer. 2018; 16(6):445-452. DOI: 10.1016/j.clgc.2018.07.003. View

DCosta J, Goldsmith J, Wilson J, Bryan R, Ward D . A Systematic Review of the Diagnostic and Prognostic Value of Urinary Protein Biomarkers in Urothelial Bladder Cancer. Bladder Cancer. 2016; 2(3):301-317. PMC: 4969711. DOI: 10.3233/BLC-160054. View

Morizawa Y, Miyake M, Shimada K, Hori S, Tatsumi Y, Nakai Y . Neutrophil-to-lymphocyte ratio as a detection marker of tumor recurrence in patients with muscle-invasive bladder cancer after radical cystectomy. Urol Oncol. 2016; 34(6):257.e11-7. DOI: 10.1016/j.urolonc.2016.02.012. View

Viers B, Boorjian S, Frank I, Tarrell R, Thapa P, Karnes R . Pretreatment neutrophil-to-lymphocyte ratio is associated with advanced pathologic tumor stage and increased cancer-specific mortality among patients with urothelial carcinoma of the bladder undergoing radical cystectomy. Eur Urol. 2014; 66(6):1157-64. DOI: 10.1016/j.eururo.2014.02.042. View

Flaig T, Spiess P, Agarwal N, Bangs R, Boorjian S, Buyyounouski M . NCCN Guidelines Insights: Bladder Cancer, Version 5.2018. J Natl Compr Canc Netw. 2018; 16(9):1041-1053. DOI: 10.6004/jnccn.2018.0072. View

10.

Suh J, Jung J, Jeong C, Kwak C, Kim H, Ku J . Clinical Significance of Pre-treated Neutrophil-Lymphocyte Ratio in the Management of Urothelial Carcinoma: A Systemic Review and Meta-Analysis. Front Oncol. 2020; 9:1365. PMC: 6927426. DOI: 10.3389/fonc.2019.01365. View

11.

Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F . Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends. Eur Urol. 2016; 71(1):96-108. DOI: 10.1016/j.eururo.2016.06.010. View

12.

Cantiello F, Russo G, Vartolomei M, Abu Farhan A, Terracciano D, Musi G . Systemic Inflammatory Markers and Oncologic Outcomes in Patients with High-risk Non-muscle-invasive Urothelial Bladder Cancer. Eur Urol Oncol. 2019; 1(5):403-410. DOI: 10.1016/j.euo.2018.06.006. View

13.

Dan J, Zhang Y, Peng Z, Huang J, Gao H, Xu L . Postoperative neutrophil-to-lymphocyte ratio change predicts survival of patients with small hepatocellular carcinoma undergoing radiofrequency ablation. PLoS One. 2013; 8(3):e58184. PMC: 3597630. DOI: 10.1371/journal.pone.0058184. View

14.

Stotz M, Pichler M, Absenger G, Szkandera J, Arminger F, Schaberl-Moser R . The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. Br J Cancer. 2013; 110(2):435-40. PMC: 3899781. DOI: 10.1038/bjc.2013.785. View

15.

Ceylan C, Doluoglu O, Keles I, Gazel E, Temucin T, Odabas O . Importance of the neutrophil-to-lymphocyte ratio in muscle-invasive and non-muscle invasive bladder tumors. Urologia. 2014; 81(2):120-4. DOI: 10.5301/uro.5000031. View

16.

Vartolomei M, Mathieu R, Margulis V, Karam J, Roupret M, Lucca I . Promising role of preoperative neutrophil-to-lymphocyte ratio in patients treated with radical nephroureterectomy. World J Urol. 2016; 35(1):121-130. PMC: 5233730. DOI: 10.1007/s00345-016-1848-9. View

17.

Frantzi M, van Kessel K, Zwarthoff E, Marquez M, Rava M, Malats N . Development and Validation of Urine-based Peptide Biomarker Panels for Detecting Bladder Cancer in a Multi-center Study. Clin Cancer Res. 2016; 22(16):4077-86. DOI: 10.1158/1078-0432.CCR-15-2715. View

18.

Wu S, Zhao X, Wang Y, Zhong Z, Zhang L, Cao J . Pretreatment Neutrophil-Lymphocyte Ratio as a Predictor in Bladder Cancer and Metastatic or Unresectable Urothelial Carcinoma Patients: a Pooled Analysis of Comparative Studies. Cell Physiol Biochem. 2018; 46(4):1352-1364. DOI: 10.1159/000489152. View

19.

Can C, Baseskioglu B, Yilmaz M, Colak E, Ozen A, Yenilmez A . Pretreatment parameters obtained from peripheral blood sample predicts invasiveness of bladder carcinoma. Urol Int. 2012; 89(4):468-72. DOI: 10.1159/000343278. View

20.

Grivennikov S, Greten F, Karin M . Immunity, inflammation, and cancer. Cell. 2010; 140(6):883-99. PMC: 2866629. DOI: 10.1016/j.cell.2010.01.025. View