scholarly journals Pretreatment Neutrophil-to-Lymphocyte Ratio Can Predict the Prognosis in Bladder Cancer Patients Who Receive Gemcitabine and Nedaplatin Therapy

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Shinji Ohtake ◽  
Takashi Kawahara ◽  
Ryo Kasahara ◽  
Hiroki Ito ◽  
Kimito Osaka ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Neutrophil To Lymphocyte Ratio ◽  
Prognostic Impact ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Kaplan Meier ◽  
Advanced Bladder Cancer ◽  
Overall Mortality

Introduction and Objectives. Neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a simple marker of the systemic inflammatory response in critical care patients. We previously assessed the utility of NLR as a biomarker to predict tumor recurrence and cancer death in bladder cancer patients who underwent radical cystectomy. In this study, we evaluated the prognostic impact of NLR in bladder cancer patients who received gemcitabine and nedaplatin (GN) chemotherapy.Methods. A total of 23 patients who received GN chemotherapy for advanced bladder cancer were enrolled in this study. The cut-off point of NLR according to the sensitivity and specificity levels was derived from the area under receiver operator characteristics (AUROC) curve plotted for disease progression or overall mortality.Results. The NLR cut-off point was determined as 4.14 for both tumor progression and overall mortality. Median progression-free survival (PFS)/overall survival (OS) in the higher NLR group (NLR ≥ 4.14) and lower NLR group (NLR < 4.14) were 194/468 days versus 73/237 days, respectively. Kaplan-Meier analysis showed that higher NLR significantly correlated with poorer PFS (p=0.011) and OS (p=0.045).Conclusions. NLR may serve as a new biomarker to predict responses to GN-based chemotherapy in advanced bladder cancer patients and/or their prognosis.

scholarly journals Radiotherapy-Induced High Neutrophil-to-Lymphocyte Ratio is a Negative Prognostic Factor in Patients with Breast Cancer

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1896
Author(s):  
Chang Ik Yoon ◽  
Dooreh Kim ◽  
Sung Gwe Ahn ◽  
Soong June Bae ◽  
Chihwan Cha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Tumor Recurrence ◽  
Neutrophil To Lymphocyte Ratio ◽  
Significant Prognostic Factor ◽  
Prognostic Impact ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Lymphocyte Ratio

Radiotherapy (RT) is the standard of care following breast-conserving operation in breast cancer patients. The neutrophil-to-lymphocyte ratio (NLR) reflects the systemic change caused as a result of the radiotherapy. We aimed to evaluate the association between RT and the change in NLR following the receipt of RT, and to investigate the prognostic impact. We retrospectively reviewed NLR values of breast cancer patients taken before the administration of the first and the last session of RT. The cut-off point for the NLR was determined using the Youden index and receiver operating characteristic (ROC) curve within the training set. Recurrence-free survival (RFS), distant metastasis free survival, and overall survival were the main outcomes. Patients with an NLR higher than 3.49 after RT were classified to an RT-induced high NLR group and showed a significantly higher recurrence rate compared to those with low NLR (p < 0.001). In a multivariate Cox proportional hazards model, RT-induced high NLR remained a significant prognostic factor (HR 2.194, 95% CI 1.230–3.912, p = 0.008 for tumor recurrence. We demonstrated that an increase in NLR over the course of RT has a negative impact on survival, putting these patients with RT-susceptible host immunity at a higher risk of tumor recurrence.

scholarly journals Prognostic value of neutrophil-to-lymphocyte ratio and location in patients with EGFR mutant metastatic non-small cell lung cancer treated with TKIs

2020 ◽  
Author(s):  
Xueqi Xie ◽  
Xiaolin Li ◽  
Wenjie Tang ◽  
Jinlong Chen ◽  
Minghuan Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Value ◽  
Progression Free Survival ◽  
Tumor Location ◽  
Small Cell ◽  
Neutrophil To Lymphocyte Ratio ◽  
Small Cell Lung ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Primary Location

Abstract Background: Targeted therapy with the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) has improved the field of metastatic non-small cell lung cancer treatment. Higher neutrophil-to-lymphocyte ratio (NLR) and lower relative lymphocyte counts as inflammatory indicators and associated with worse overall survival and progression free survival (PFS) in several tumor types. Few studies focused on these inflammation markers in context of TKIs eras. Methods: Patients with advanced EGFR mutation NSCLC treated with TKIs were included. Pre-treatment NLR means neutrophil to lymphocyte ratio measured in peripheral blood within one week before treating with TKIs. The baseline clinical characteristics of each group were compared by chi-square and t tests. Cox regression analyses were used to evaluate prognostic value of peripheral blood parameters on progression free survival (PFS). All prognostic factors were explored with multivariable regression. Results: We retrospectively analyzed 221 patients with metastatic NSCLC harboring exon 19 deletion, 21 L858R or rare mutation and receiving TKIs. Finally, a total of 190 patients were analyzed. The optimal cutoff values for pretreatment absolute lymphocyte count (Lym), lymphocyte percentage (Lym%), absolute neutrophil count (Neu), the percentage of neutrophil granulocytes (Neu%) and NLR were 1.625 B, 18.8%, 3.675a, 51.8% and 4.965, respectively. Patients with high neutrophil percent (13.0 months vs 18.8 months, P=0.003), absolute neutrophil counts (12.0 months vs 14.5 months, P=0.014) and NLR (7.0 months vs 15.2 months, P<0.001, one-year PFS Rate, 55.3%, respectively) had worse PFS. In contrast, patients with high absolute lymphocyte counts (13.0 months vs 16.5 months, P=0.012) and lymphocyte percent (8.8 months vs 15.3months, P<0.001) had a better PFS. Besides, tumor location was also an important factor for prognosis (11.6 months vs 14.3 months, P=0.003). On multivariate analysis, NLR and primary tumor location were both identified as independent and significantly risk indicators for worse PFS. Conclusion: NLR and primary location are both independent prognostic factors for PFS in patients with metastatic EGFR mutated lung tumor. Whether or not NLR and primary location could be usefulmarkers in efficacy prediction of TKIs in advanced NSCLC calls for further investigation.

scholarly journals A descriptive report of outcomes of primary mucinous ovarian cancer patients receiving either an adjuvant gynecologic or gastrointestinal chemotherapy regimen

2019 ◽  
Vol 29 (5) ◽  
pp. 904-909
Author(s):  
Brooke A Schlappe ◽  
Qin C Zhou ◽  
Roisin O'Cearbhaill ◽  
Alexia Iasonos ◽  
Robert A Soslow ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Free Survival ◽  
Exact Test ◽  
Clinical Criteria ◽  
Kaplan Meier

ObjectiveWe described progression-free survival and overall survival in patients with primary mucinous ovarian cancer receiving adjuvant gynecologic versus gastrointestinal chemotherapy regimens.MethodsWe identified all primary mucinous ovarian cancer patients receiving adjuvant gynecologic or gastrointestinal chemotherapy regimens at a single institution from 1994 to 2016. Gynecologic pathologists using strict pathologic/clinical criteria determined diagnosis. Adjuvant therapy was coded as gynecologic or gastrointestinal based on standard agents and schedules. Clinical/pathologic/treatment characteristics were recorded. Wilcoxon rank-sum test was used for continuous variables, and Fisher’s exact test for categorical variables. Progression-free and overall survival were calculated using the Kaplan-Meier method, applying landmark analysis.ResultsOf 62 patients identified, 21 received adjuvant chemotherapy: 12 gynecologic, 9 gastrointestinal. Median age (in years) at diagnosis: 58 (range 25–68) gynecologic cohort, 38 (range 32–68) gastrointestinal cohort (p=0.13). Median body mass index at first post-operative visit: 25 kg/m2(range 18–31) gynecologic cohort, 23 kg/m2(range 18–31) gastrointestinal cohort (p=0.23). History of smoking: 6/12 (50%) gynecologic cohort, 3/9 (33%) gastrointestinal cohort (p=0.66). Stage distribution in gynecologic and gastrointestinal cohorts, respectively: stage I: 9/12 (75%) and 3/9 (33%); stage II: 2/12 (17%) and 1/9 (11%); stage III: 1/12 (8%) and 5/9 (56%) (p=0.06). Grade distribution in gynecologic and gastrointestinal cohorts, respectively: grade 1: 8/12 (67%) and 1/9 (13%); grade 2/3: 4/12 (33%) and 7/9 (88%) (p=0.03). Three-year progression-free survival: 90.9% (95% CI 50.8% to 98.7 %) gynecologic, 53.3% (95% CI 17.7% to 79.6%) gastrointestinal. Three-year overall survival: 90.9% (95% CI 50.8% to 98.7%) gynecologic, 76.2% (95% CI 33.2% to 93.5%) gastrointestinal.ConclusionOngoing international collaborative research may further define associations between chemotherapy regimens and survival.

scholarly journals Pretreatment Neutrophil-Lymphocyte Ratio as a Predictor in Bladder Cancer and Metastatic or Unresectable Urothelial Carcinoma Patients: a Pooled Analysis of Comparative Studies

2018 ◽  
Vol 46 (4) ◽  
pp. 1352-1364 ◽  
Author(s):  
Shuiqing Wu ◽  
Xiaokun Zhao ◽  
Yinhuai Wang ◽  
Zhaohui Zhong ◽  
Lei Zhang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Cancer Patients ◽  
Pooled Analysis ◽  
Risk Indicator ◽  
Advanced Tumor Stage ◽  
Free Survival ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Advanced Tumor

Background/Aims: Emerging studies have shown that the neutrophil-lymphocyte ratio (NLR) is a potential predictor in various tumors. Our study was conducted to assess the prognostic value of the pretreatment NLR in bladder cancer and metastatic or unresectable urothelial carcinoma (mUC or uUC) patients up to July 2017. The correlation between the pretreatment NLR and pathological characteristics was also evaluated in bladder cancer patients. Methods: The hazard ratio (HR) and odds ratio (OR) with the 95% confidence interval (CI) were extracted or calculated from the included studies for further pooled analysis. A total of 21 studies were included in a pooled analysis. Results: The pooled results indicated that a high pretreatment NLR was associated with reduced overall survival (OS) (HR=1.27, 95% CI=1.12-1.43), relapse-free survival (RFS) (HR=1.41, 95% CI=1.23-1.60), progression-free survival (PFS) (HR=1.75, 95% CI=1.36-2.15), disease-specific survival (DSS) and cancer-specific survival (CSS) (HR=1.27, 95% CI=1.19-1.35) in the bladder cancer patients. Additionally, an elevated pretreatment NLR suggested a worse OS rate in the mUC or uUC patients (HR=1.63, 95% CI=1.34-1.91). The pooled ORs and 95% CIs showed that a high pretreatment NLR could be a risk indicator for certain pathological features, such as lymphovascular invasion, a positive margin status and advanced tumor stage. Conclusions: our results showed that a high pretreatment NLR predicted poor prognosis in bladder cancer, mUC and uUC patients.

scholarly journals The role of neutrophil to lymphocyte ratio in patients with pTa non-muscle invasive bladder cancer

2020 ◽  
Vol 28 (1) ◽  
pp. 29-38
Author(s):  
Orsolya Mártha ◽  
Daniel Balan ◽  
Daniel Porav-Hodade ◽  
Emőke Drágus ◽  
Mihai Dorin Vartolomei ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Primary Tumor ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Kaplan Meier ◽  
Muscle Invasive

AbstractIntroduction: The peritumoral inflammatory reaction has a substantial importance in the oncologic outcome of bladder cancer (BC). One biomarker proven to be practical and accessible is the NLR (neutrophil-to-lymphocyte ratio) for high risk non-muscle invasive bladder cancer (NMIBC). The aim of the study was to investigate the role of NLR as a prognostic biomarker for disease recurrence, progression and survival of p Ta (pathological assesment of the primary tumor) NMIBC.Material and Methods: In our retrospective study we included 54 patients with pTa NMIBC from a total of 235 patients who underwent transurethral resection of bladder tumor (TURBT) during two consecutive years: January 2007 - December 2008 [median follow-up 106 months (interquartile range-IQR 68-116)]. Criteria for inclusion were: primary tumor, low-grade, with NLR available at 2 weeks prior to TURBT. NLR was considered altered if higher than 3.Results: The median age of the patients included was 63 years (IQR 55 - 72). Most of the patients had NLR---lt---3 (37 patients). Median EORTC (European Organization of Research and Treatment of Cancer) Recurrence Score was 4 (IQR 1-6), while EORTC Progression Score was 3 (IQR 0-6), respectively. Recurrence occurred in 8 out of 54 (14.81 %) patients and progression was identified in 2 out of 54 (3.70 %) patients with muscle-invasive BC during follow-up. NLR---gt---3 was not associated with clinical and pathological factors. In multivariable Cox regression analyses NLR as a continuous variable was an independent predictive factor for recurrence. Recurrence-free survival (RFS) Kaplan-Meier analysis did not show a statistical significance between NLR groups: 82.67% vs. 64.12%, p=0.26. Kaplan-Meier analysis showed a lower Progression-free survival (PFS) in the NLR---gt---3 group: 94.12% vs. 100%, p=0.04. During follow-up (106 months) 18 patients deceased with no impact of NLR as a prognostic factor in multivariable analyses. Kaplan-Meier overall survival (OS) analysis showed a 10-year OS of 70.27% in the low NLR group compared with 58.82% in the high NLR group, p=0.45.Conclusion: In this cohort, high NLR was associated with high recurrence rate in patients with Ta NMIBC. In low-risk NMIBC NLR could represent a valid biomarker for clinical usage regarding the intensity of follow-up schedule.

scholarly journals The Clinical Impact of Combining Neutrophil-to-Lymphocyte Ratio with Sarcopenia for Improved Discrimination of Progression-Free Survival in Patients with Colorectal Cancer

2022 ◽  
Vol 11 (2) ◽  
pp. 431
Author(s):  
Su Young Lee ◽  
Eric Chung ◽  
Eun-Suk Cho ◽  
Jae-Hoon Lee ◽  
Eun Jung Park ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Progression Free Survival ◽  
Clinical Impact ◽  
Cox Proportional Hazards Model ◽  
Neutrophil To Lymphocyte Ratio ◽  
Skeletal Muscle Index ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Group 4 ◽  
Group 1

This study aimed to evaluate the clinical impact of combined sarcopenia and inflammation classification (CSIC) in patients with colorectal cancer (CRC). The skeletal muscle index (SMI) and neutrophil-to-lymphocyte ratio (NLR) were measured in 1270 patients who underwent surgery between January 2005 and April 2014. A Cox proportional hazards model was used to evaluate the correlation of sarcopenia, NLR, and CSIC, with progression-free survival (PFS). The integrated area under the curve (iAUC) was used to compare the discriminatory performance of each model. Using the cut-off values for SMI suggested by Martin et al. and for an NLR of 2.26, the CSIC was defined as follows: nonsarcopenia with low NLR (group 1), nonsarcopenia with high NLR (group 2), sarcopenia with low NLR (group 3), and sarcopenia with high NLR (group 4). Sarcopenia alone was not statistically significant. Multivariate analysis identified that CSIC (group 4 vs. group 1; hazard ratio (HR), 1.726; 95% CI, 1.130–2.634; p = 0.011) and NLR (HR, 1.600; 95% CI, 1.203–2.128; p = 0.001) were independently associated with PFS. The CSIC improved the prediction accuracy of PFS compared with NLR (iAUC mean difference = 0.011; 95% CI, 0.0018–0.028). In conclusion, the combination of sarcopenia and NLR could improve prognostic accuracy, and thus compensate for the limitation of sarcopenia.

scholarly journals Prognostic Significance of The Neutrophil-To-Lymphocyte Ratio in Patients With Non-Muscle Invasive Bladder Cancer Treated With Intravesical Bacillus Calmette–Guérin and The Relationship With The CUETO Scoring Model

2020 ◽  
Author(s):  
Jin Woo Kim ◽  
Jae-Wook Chung ◽  
Eun Hye Lee ◽  
So Young Chun ◽  
Dong Jin Park ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Tumor Recurrence ◽  
Risk Model ◽  
Bacillus Calmette Guerin ◽  
Muscle Invasive Bladder Cancer ◽  
Free Survival ◽  
Scoring Model ◽  
Lymphocyte Ratio ◽  
Kaplan Meier ◽  
Muscle Invasive

Abstract Background: The neutrophil-to-lymphocyte ratio (NLR) is a marker of the systemic inflammatory response, which is associated with tumor recurrence and progression. In this study, we evaluated the predictability of a modified Club Urológico Español de Tratamiento Oncológico (CUETO) scoring model and preoperative NLR in patients with non-muscle invasive bladder cancer (NMIBC). Methods: From August 2005 to May 2016, a total of 281 patients received intravesical bacillus Calmette–Guérin therapy after transurethral resection of a bladder tumor. The pathologic stage of all patients was Ta or T1. Multivariate Cox regression analysis and Kaplan–Meier curves were used to evaluate the prognosis predictability of the CUETO risk model and NLR. Of 281 patients, 84 (29.9%) experienced recurrence and 14 (5.0%) developed progression. The mean follow-up period was 46 months. The cut-off value for NLRs was 2.29. Results: Of the study patients, 108 (38.4%) displayed a high NLR (> 2.29). In Kaplan–Meier curve analysis, a high NLR was associated with lower recurrence-free survival (RFS) (P < 0.001) and progression-free survival (PFS) (P = 0.002). CUETO scores were associated with RFS (P < 0.001), but not with PFS (P = 0.423). A combination of NLRs and the CUETO risk model correlated with RFS (P < 0.001) and PFS (P = 0.002). In multivariate analysis, female gender, concomitant carcinoma in situ (CIS), tumor number >3, recurrent tumors, and a high NLR were independent factors predicting recurrence (all P < 0.05). Concomitant CIS, recurrent tumors, and a high NLR were independent factors for predicting progression (all P < 0.05). Conclusion: In patients with NMIBC, an NLR >2.29 was identified as a significant factor for predicting tumor recurrence and progression. Inclusion of preoperative NLR enhanced the accuracy of the CUETO model to predict disease progression. We therefore recommend that patients with a high NLR receive more aggressive management.

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