Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr 27;8(37):62681-62692.
doi: 10.18632/oncotarget.17467. eCollection 2017 Sep 22.

Prognostic value of neutrophil-to-lymphocyte ratio in urothelial carcinoma of the upper urinary tract and bladder: a systematic review and meta-analysis

Xintao Li  1 , Xin Ma  1 , Lu Tang  1 , Baojun Wang  1 , Luyao Chen  1 , Fan Zhang  1 , Xu Zhang  1
Affiliations

Prognostic value of neutrophil-to-lymphocyte ratio in urothelial carcinoma of the upper urinary tract and bladder: a systematic review and meta-analysis

Xintao Li et al. Oncotarget. .

Abstract

The neutrophil-to-lymphocyte ratio (NLR) is an inflammation marker that has prognostic value for various tumors, but its prognostic value in urothelial carcinoma (UC) remains controversial. This meta-analysis investigated the prognostic value of NLR in UC. A systematic search was performed on PubMed, ISI Web of Science, and Embase for studies focusing on the association between NLR and clinical features or prognosis of UC and published until November 2016. Prognostic outcomes and clinical features were collected and analyzed. A total of 11,538 patients from 32 studies were included in the meta-analysis. Increased pretreatment NLR predicted poor overall survival (hazard ratio [HR] = 1.72, 95% confidence interval [CI] = 1.45-2.05), progression free survival (HR = 1.68, 95% CI = 1.44-1.96), and cancer specific survival (HR = 1.64, 95% CI = 1.39-1.93) in all the patients. The increased pretreatment NLR was correlated with increased lymphovascular invasion (HR = 1.29, 95% CI = 1.17-1.43), high tumor T stage (HR = 1.25, 95% CI = 1.12-1.39), and tumor grade (HR = 1.07, 95% CI = 1.01-1.14) but not with lymph node involvement, carcinoma in situ, multifocality, or positive margin. Our meta-analysis indicated that NLR could predict the prognosis for UC and was associated with UC progression in terms of lymphovascular invasion, tumor T stage, and tumor grade.

Keywords: inflammation; meta-analysis; neutrophil-to-lymphocyte ratio; prognosis; urothelial cancer.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST The authors have nothing to disclose.

Figures

Figure 1
Figure 1. Flowchart of selection of studies for inclusion in meta-analysis
Figure 2
Figure 2. Meta-analysis of NLR value and OS in UC patients
Figure 3
Figure 3. Meta-analysis of NLR value and PFS in UC patients
Figure 4
Figure 4. Meta-analysis of NLR value and CSS in UC patients
Figure 5
Figure 5. Begg’s and Egger’s test results for UC patients’ OS
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Roupret M, Zigeuner R, Palou J, Boehle A, Kaasinen E, Sylvester R, Babjuk M, Oosterlinck W. European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: 2011 update. European urology. 2011;59:584–594. - PubMed
    1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–249. - PubMed
    1. Humphrey PA, Moch H, Cubilla AL, Ulbright TM, Reuter VE. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part B: Prostate and Bladder Tumours. European urology. 2016;70:106–119. - PubMed
    1. Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BW, Comperat E, Sylvester RJ, Kaasinen E, Bohle A, Palou Redorta J, Roupret M, European Association of U EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. European urology. 2013;64:639–653. - PubMed
    1. Lughezzani G, Burger M, Margulis V, Matin SF, Novara G, Roupret M, Shariat SF, Wood CG, Zigeuner R. Prognostic factors in upper urinary tract urothelial carcinomas: a comprehensive review of the current literature. European urology. 2012;62:100–114. - PubMed

LinkOut - more resources