Annals of Surgical Oncology

, Volume 23, Supplement 5, pp 1039–1047 | Cite as

The Preoperative Neutrophil-to-lymphocyte Ratio is a Novel Biomarker for Predicting Worse Clinical Outcomes in Non-muscle Invasive Bladder Cancer Patients with a Previous History of Smoking

  • Koichiro Ogihara
  • Eiji Kikuchi
  • Kazuyuki Yuge
  • Yoshinori Yanai
  • Kazuhiro Matsumoto
  • Akira Miyajima
  • Hirotaka Asakura
  • Mototsugu Oya
Urologic Oncology

Abstract

Purpose

We speculated that a heterogeneous population of non-muscle invasive bladder cancer (NMIBC) patients with a previous history of smoking may be more precisely stratified by a biomarker associated with tumor aggressiveness and then focused on the preoperative neutrophil-to-lymphocyte ratio (pre-NLR), which is a simple index of systemic inflammation.

Methods

Our study population comprised 605 patients initially diagnosed with NMIBC at our 3 institutions between 1995 and 2013. We analyzed the relationships between pre-NLR levels and clinical outcomes in NMIBC. A pre-NLR level of ≥2.2 was defined as elevated according to a calculation by a receiver-operating curve analysis.

Results

In overall, a total of 296 patients (48.9 %) had pre-NLR ≥ 2.2, and the pre-NLR level was one of independent risk factors for tumor recurrence and stage progression. Among 344 patients with a previous history of smoking, 184 (53.5 %) had pre-NLR ≥ 2.2 and the pre-NLR level was one of independent risk factors for tumor recurrence and stage progression. The 5-year recurrence-free survival and progression-free survival rates in patients with pre-NLR < 2.2 were 66.3 and 97.5 %, respectively, which were significantly higher than those in their counterparts (31.7 and 90.4 %, p < 0.001). In either subgroup of patients who were current smokers (N = 175) or former smokers (N = 169), the pre-NLR level was the only independent risk factor for tumor recurrence. The pre-NLR level was not associated with tumor recurrence or stage progression in 261 nonsmoking patients.

Conclusions

Pre-NLR levels may be a useful marker for identifying worse clinical outcomes in NMIBC patients, particularly those with a previous history of smoking.

Keywords

Tumor Recurrence MIBC Stage Progression Ideal Cutoff Predict Tumor Recurrence 

Notes

Disclosure

All authors certify that this study has no financial or other relationships that 3 institutions might lead to a conflict of interest.

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Koichiro Ogihara
    • 1
  • Eiji Kikuchi
    • 1
  • Kazuyuki Yuge
    • 1
  • Yoshinori Yanai
    • 2
  • Kazuhiro Matsumoto
    • 1
  • Akira Miyajima
    • 1
  • Hirotaka Asakura
    • 3
  • Mototsugu Oya
    • 1
  1. 1.Department of UrologyKeio University School of MedicineTokyoJapan
  2. 2.Department of UrologySaiseikai Central HospitalTokyoJapan
  3. 3.Department of UrologySaitama Medical University HospitalSaitamaJapan

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