Minerva urologica e nefrologica = The Italian journal of urology and nephrology · 2018
Prognostic value of preoperative systemic inflammation markers in localized upper tract urothelial cell carcinoma: a large, multicenter cohort analysis.
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Son Sumin, Hwang Eu-Chang, Jung Seung-Il, Kwon Dong-Deuk, Choi Seock-Hwan, Kwon Tae-Gyun, Noh Joon-Hwa, Kim Myung-Ki, Seo Ill-Young, Kim Chul-Sung, Kang Sung-Gu, Cheon Jun, Ha Hong-Koo, Jeong Chang-Wook, Ku Ja-Hyeon, Kwak Cheol, Kim Hyeon-Hoe
Аннотация
BACKGROUND: The aim of this study was to investigate the prognostic value of preoperative systemic inflammation markers in upper tract urothelial carcinoma (UTUC).
METHODS: A total of 1137 patients who underwent radical nephroureterectomy with bladder cuff excision at 9 institutions from 2004 to 2015, were retrospectively reviewed. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for each patient were calculated. Univariable and multivariable analysis was performed using the Cox proportional hazards regression model. Cut-off values for NLR and PLR were calculated using a receiver operating characteristic curve.
RESULTS: The median follow-up period was 39.1 (interquartile range: 18.3-63.8) months. Univariable analysis revealed that GPS, mGPS, PLR, and NLR (all, P=0.001) were significantly associated with both recurrence-free survival (RFS) and cancer-specific survival (CSS). Multivariable analysis revealed that GPS (P=0.001), PLR (hazards ratio [HR] =1.32; 95% CI: 1.08-1.62, P=0.007 and HR =1.87; 95% CI: 1.21-2.92, P=0.005), NLR (HR =1.38; 95% CI: 1.12-1.69, P=0.003 and HR =1.70; 95% CI: 1.10-2.62, P=0.017) were significantly associated with RFS and CSS.
CONCLUSIONS: Our results suggest that preoperative systemic inflammation markers such as GPS, PLR, and NLR are independent prognostic factors in patients with UTUC after surgery.
METHODS: A total of 1137 patients who underwent radical nephroureterectomy with bladder cuff excision at 9 institutions from 2004 to 2015, were retrospectively reviewed. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for each patient were calculated. Univariable and multivariable analysis was performed using the Cox proportional hazards regression model. Cut-off values for NLR and PLR were calculated using a receiver operating characteristic curve.
RESULTS: The median follow-up period was 39.1 (interquartile range: 18.3-63.8) months. Univariable analysis revealed that GPS, mGPS, PLR, and NLR (all, P=0.001) were significantly associated with both recurrence-free survival (RFS) and cancer-specific survival (CSS). Multivariable analysis revealed that GPS (P=0.001), PLR (hazards ratio [HR] =1.32; 95% CI: 1.08-1.62, P=0.007 and HR =1.87; 95% CI: 1.21-2.92, P=0.005), NLR (HR =1.38; 95% CI: 1.12-1.69, P=0.003 and HR =1.70; 95% CI: 1.10-2.62, P=0.017) were significantly associated with RFS and CSS.
CONCLUSIONS: Our results suggest that preoperative systemic inflammation markers such as GPS, PLR, and NLR are independent prognostic factors in patients with UTUC after surgery.