Prognostic utility of the combination of pretreatment monocyte-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with NMIBC after transurethral resection

Aim: To investigate and validate predictive value of combination of pretreatment monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) for disease free survival (DFS) and overall survival (OS) in nonmuscle invasive bladder cancer after transurethral resection. Materials & methods: Total 358 patients enrolled were assigned into three (MLR-NLR 0, 1 and 2) groups per the cut-off values of MLR and NLR. Results: Kaplan–Meier curves showed MLR, NLR and their combination were statistically associated with DFS (p < 0.001) and OS (p < 0.001). Univariate and multivariate COX regression analyses revealed that combination of MLR with NLR was an independent prognostic predictor for both DFS (HR: 3.080; 95% CI: 1.870–5.074; p < 0.001 for MLR-NLR 2 vs MLR-NLR 0) and OS (HR: 2.815; 95% CI: 1.778–4.456; p < 0.001 for MLR-NLR 2 vs MLR-NLR 0). Calibration plots and decision curve analysis exhibited combination of MLR and NLR had good calibration accuracy with potential clinical usefulness. Conclusion: Combined MLR and NLR is a prognostic predictive biomarker in nonmuscle invasive bladder cancer after transurethral resection.

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Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Nonmuscle-Invasive Bladder Cancer Treated with GreenLight Laser Vaporization

Photobiomodulation Photomedicine and Laser Surgery ◽

10.1089/photob.2018.4592 ◽

2019 ◽

Vol 37 (5) ◽

pp. 312-317

Author(s):

Fei Luo ◽

Chunlei Ma ◽

Jianhui Wu ◽

Jian Li

Keyword(s):

Bladder Cancer ◽

Prognostic Value ◽

Neutrophil To Lymphocyte Ratio ◽

Invasive Bladder Cancer ◽

Laser Vaporization ◽

Lymphocyte Ratio ◽

Greenlight Laser ◽

Nonmuscle Invasive Bladder Cancer

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[53] Neutrophil-to-lymphocyte ratio in non-muscle-invasive bladder cancer

Arab Journal of Urology ◽

10.1016/j.aju.2018.10.006 ◽

2018 ◽

Vol 16 (sup1) ◽

pp. S26-S26

Author(s):

Anés Sempere ◽

Paula Samper

Keyword(s):

Bladder Cancer ◽

Neutrophil To Lymphocyte Ratio ◽

Invasive Bladder Cancer ◽

Muscle Invasive Bladder Cancer ◽

Lymphocyte Ratio ◽

Muscle Invasive

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Combination of C-Reactive Protein and Neutrophil-to-Lymphocyte Ratio as a Novel Prognostic Index in Patients With Bladder Cancer After Radical Cystectomy

Frontiers in Oncology ◽

10.3389/fonc.2021.762470 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yidi Wang ◽

Keyi Wang ◽

Jinliang Ni ◽

Houliang Zhang ◽

Lei Yin ◽

...

Keyword(s):

Bladder Cancer ◽

Radical Cystectomy ◽

Cox Regression ◽

Roc Curves ◽

Neutrophil To Lymphocyte Ratio ◽

Postoperative Survival ◽

C Reactive Protein ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

T Stage

BackgroundInflammation is widely considered an important hallmark of cancer and associated with poor postoperative survival. The objective of this study is to assess the significance of preoperative C-NLR, a new inflammation-based index that includes preoperative C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR), on therapeutic outcomes for bladder cancer (BC) patients after radical cystectomy (RC).Materials and MethodsBC patients who underwent RC between 2010 and 2019 were retrospectively analyzed from our medical center. The predictive effect of CRP, NLR, and C-NLR on the survival of BC patients were analyzed by the receiver operating characteristic (ROC) curves. The relationship between C-NLR and postoperative survival was investigated by Cox regression. The corresponding nomograms were built based on the Cox regression results of overall survival (OS) and disease-free survival (DFS), which were further validated by ROC curves, decision curve analysis (DCA) curves, and calibration curves.ResultsOf the 199 eligible patients, 83 (41.70%) were classified as high C-NLR group and the remaining 116 (58.30%) were classified as low C-NLR group. ROC analysis showed that C-NLR had the largest area under curve (AUC) compared to CRP and NLR. Multivariate analysis revealed that T-stage and C-NLR [high C-NLR vs. low C-NLR, hazard ratio (HR) = 2.478, 95% confidence interval (CI), 1.538–3.993, p < 0.001] were independent predictors of OS, whereas T-stage, M-stage, and C-NLR (high C-NLR vs. low C-NLR, HR = 2.817, 95% CI, 1.667–4.762, p < 0.001) were independent predictors of DFS. ROC and DCA analysis demonstrated better accuracy and discrimination of 3- and 5-year OS and DFS with C-NLR-based nomogram compared to TNM stage. The calibration curve reconfirmed the accurate predicting performance of nomograms.ConclusionC-NLR is a reliable predictor of long-term prognosis of BC patients after RC and will contribute to the optimization of individual therapy for BC patients.

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