Preoperative fibrinogen-to-prealbumin ratio and neutrophil lymphocyte ratio/prealbumin ratio versus platelet distribution width-to-platelet count ratio as a prognostic predictor for bladder cancer
Abstract Background Evidence indicates that preoperative fibrinogen/prealbumin (FPR), neutrophil lymphocyte ratio/prealbumin ratio (NLR/PA) and platelet distribution width-to-platelet count ratio (PDW/PLT) possess prognostic potential in numerous malignancies. However, their roles in bladder cancer remain unclear. In this study, we investigated the association between FPR, NLR/PA versus PDW/PLT and the prognosis in bladder cancer patients. Methods The clinical data of 147 patients with bladder cancer treated in Nantong cancer hospital from January 2009 to August 2014 were retrospectively analyzed. According to ROC curve, the optimal critical value of FPR, NLR/PA and PDW/PLT were 0.1084, 0.1045 and 0.1210 respectively. The patients were followed up for 5 years to observe the survival of the patients, and the clinicopathological data were statistically analyzed. Cox regression analysis was used for univariate and multivariate analysis. Finally, on this basis, the nomogram is constructed for internal verification. Results All patients were followed up for 5 years. A total of 102 patients survived with a survival rate of 69.4%, 45 patients died with a mortality rate of 30.6%. Further stratified analysis showed that the group with low FPR, low NLR/PA and low PDW/PLT had the best prognosis, while the group with high FPR, high NLR/PA and high PDW/PLT had the worst prognosis. Cox multivariate analysis showed that preoperative FPR, NLR/PA and PDW/PLT were independent risk factors for tumor progression (p = 0.007, p = 0.013, p = 0.000). The decrease of FPR, NLR/PA and PDW/PLT can significantly prolong OS and PFS in patients with bladder cancer. In internal validation, the c-index of the nomogram was 0.8140 (95% CI: 0.7577–0.8703). Conclusions Preoperative FPR and NLR/PA versus PDW/PLT can be an independent prognostic factor in bladder cancer patients and are associated with clinicopathological characteristics. They have a specific value in assessing the prognosis of bladder cancer patients.