A Multi-Institutional Validation of the Prognostic Value of the Neutrophil-to-Lymphocyte Ratio for Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy

作者：Tanaka Nobuyuki; Kikuchi Eiji^*; Kanao Kent; Matsumoto Kazuhiro; Shirotake Suguru; Miyazaki Yasumasa; Kobayashi Hiroaki; Kaneko Gou; Hagiwara Masayuki; Ide Hiroki; Obata Jun; Hoshino Katsura; Hayakawa Nozomi; Kosaka Takeo; Hara Satoshi; Oyama Masafumi; Momma Tetsuo; Nakajima Yosuke; Jinzaki Masahiro; Oya Mototsugu

来源：Annals of Surgical Oncology, 2014, 21(12): 4041-4048.

DOI：10.1245/s10434-014-3830-3

To externally validate the prognostic impact of preoperative neutrophil-lymphocyte ratio (pre-NLR) in patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU). %26lt;br%26gt;A total of 665 patients from 12 institutions were included. The median follow-up was 28 months. Associations between pre-NLR level and outcome were assessed using multivariate analysis. A pre-NLR level of %26gt; 3.0 was defined as elevated. %26lt;br%26gt;Pre-NLR levels were elevated in 184 patients (27.7 %), and pre-NLR elevation was significantly associated with worse pathological features such as tumor grade 3, advanced pT stage, positive lymphovascular invasion (LVI), and lymph node involvement in RNU specimens. The 5-year recurrence-free and cancer-specific survival rates were 57.0 % (p %26lt; 0.001) and 60.2 % (p %26lt; 0.001), respectively, in patients with elevated pre-NLR, and 69.2 and 77.3 %, respectively, in their counterparts. Multivariate analysis showed that elevated pre-NLR was an independent risk factor for predicting subsequent disease recurrence (p = 0.037; hazard ratio (HR) 1.38) and cancer-specific mortality (p = 0.036;, HR 1.47), although the addition of pre-NLR slightly improved the accuracies of the base model for predicting both disease recurrence and cancer-specific mortality to 79.8 % (p = 0.041) and 83.0 % (p = 0.039), respectively (gain in predictive accuracy: 0.2 and 0.1 %, respectively). %26lt;br%26gt;This multi-institutional study revealed that elevated pre-NLR was significantly associated with worse pathological features such as tumor grade 3, advanced pT stage, positive LVI, and lymph node involvement in RNU specimens, and elevated pre-NLR was an independent risk factor of disease recurrence and cancer-specific mortality in UTUC patients treated with RNU.

• 出版日期2014-11