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. 2014 May 13;110(10):2531-6.
doi: 10.1038/bjc.2014.180. Epub 2014 Apr 1.

Validation of the pretreatment derived neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma

O Dalpiaz  1 , M Pichler  2 , S Mannweiler  3 , J M Martín Hernández  1 , T Stojakovic  4 , K Pummer  1 , R Zigeuner  1 , G C Hutterer  1
Affiliations

Validation of the pretreatment derived neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma

O Dalpiaz et al. Br J Cancer. .

Abstract

Background: The value of a combined index of neutrophil and white cell counts, named derived neutrophil-lymphocyte ratio (dNLR), has recently been proposed as a prognosticator of survival in various cancer types. We investigated the prognostic role of the dNLR in a large European cohort of patients with upper tract urothelial carcinoma (UTUC).

Methods: Data from 171 non-metastatic UTUC patients, operated between 1990 and 2012 at a single tertiary academic centre, were evaluated retrospectively. Cancer-specific- (CSS) as well as overall survival (OS) were assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of the dNLR, multivariate proportional Cox-regression models were applied. Additionally, the influence of the dNLR on the predictive accuracy of the multivariate model was further determined by Harrell's concordance index (c-index).

Results: The median follow-up period was 31 months. An increased dNLR was statistically significantly associated with shorter CSS (log-rank P=0.004), as well as with shorter OS (log-rank P=0.002). Multivariate analysis identified dNLR as an independent predictor for CSS (hazard ratio, HR=1.16, 95% confidence interval, CI=1.01-1.35, P=0.045), as well as for OS (HR=1.21, 95% CI=1.09-1.34, P<0.001). The estimated c-index of the multivariate model for OS was 0.68 without dNLR and 0.73 when dNLR was added.

Conclusions: Patients with a high pretreatment dNLR could be predicted to show subsequently higher cancer-specific- as well as overall mortality after surgery for UTUC compared with those with a low pretreatment dNLR. Thus, this combined index should be considered as a potential prognostic biomarker in future.

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Figures

Figure 1
Figure 1
Cancer-specific survival after surgery stratified by low (<1.5) and high (⩾1.5) preoperative dNLR.
Figure 2
Figure 2
Overall survival after surgery stratified by low (<1.5) and high (⩾1.5) preoperative dNLR.
See this image and copyright information in PMC

References

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