The prognostic value of the neutrophil-to-lymphocyte ratio in patients with muscle-invasive bladder cancer treated with neoadjuvant chemotherapy and radical cystectomy
BAUS ePoster online library. Hampson A. Jun 24, 2019; 259511; P2-7
Dr. Alexander Hampson
Dr. Alexander Hampson
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Abstract
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INTRODUCTION

The neutrophil-to-lymphocyte ratio(NLR) is an attractive biomarker because it is derived from routine bloodwork and is available at no additional cost.The prognostic value of NLR in patients receiving neoadjuvant chemotherapy(NAC) before radical cystectomy is not yet established

METHOD
A retrospective analysis was performed on patients with MIBC who received NAC prior to radical cystectomy (RC) between 2000 and 2013 at one of 19 across Europe and North America.Patients were split into a low(≤3) and high(>3) NLR group.Demographic and clinical parameters were compared between the groups using Student's t test, chi-squared or Fisher's exact test.Putative risk factors for disease-specific and overall survival were analysed.

RESULTS

Complete data was available for analysis from 340 patients (199 with NLR ≤3 and 141 with NLR >3).Age was higher in the NLR>3 group (64.5±9.2 vs 61.5± 9.3 p=0.003) while more NLR≤3 patients had lymphovascular invasion present at the time of transurethral bladder tumor resection(60.3% vs 48.2% p=0.03).Other demographic and pre-operative characteristics did not differ significantly between groups.More patients in the NLR>3 group had residual MIBC after NAC than the NLR ≤ 3 group(70.8% vs 58.3%,p=0.049).In logistic regression for predictors of response,NLR was the only significant risk factor (OR: 0.36,p=0.003).NLR was also a significant risk factor for both disease-specific and overall survival(HR:2.4 p=0.006 and HR:1.8,p=0.02).

CONCLUSION:
NLR >3 is associated with lower response rate to NAC as well as shorter disease-specific and overall survival.This suggests that NLR can be a simple tool that can aid in MIBC risk stratification in clinical practice upon further validation.
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