The use of preoperative neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio in predicting survival and groin node involvement of patients with squamous cell carcinoma of penis

• Published in: Urology annals 2021-10, Vol.13 (4), p.391-396
• Main Authors: Jindal, Tarun, Pawar, Pravin, Agarwal, Sanjit, Jain, Prateek, Meena, Monika, Sarwal, Ankush, Dhanalakshmi, M
• Format: Article
• Language: English
• Subjects: Cancer; cancer-specific survival; Genital cancers; inflammation; lymph nodes; Lymphocytes; metastasis; Neutrophils; Original; Patient outcomes; penile cancer; Penis; Prognosis; Squamous cell carcinoma; Surgery
• ISSN: 0974-7796; 0974-7834; 0974-7834
• DOI: 10.4103/UA.UA_112_20

Introduction: The association between inflammation and malignancies is being recognized. In this study, we assessed the use of preoperative neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) in predicting cancer-specific survival (CSS) and inguinal node involvement in patients with carcinoma penis. Methods: Sixty-nine patients operated for squamous cell carcinoma penis with inguinal node dissection between 2012 and 2020 were identified. We recorded the type of surgery (partial/total penectomy), T stage, grade, lymphovascular invasion (LVI), perineural invasion (PNI), pathological status of inguinal nodes and nodal stage (pN1-3), extranodal extension (ENE), and CSS. The hemogram performed within 2 weeks of surgery was used for calculating NLR and LMR. Results: Partial penectomy was the most common surgery (65.22%) and pT2 was the most common stage (53.62%). Grade 2 was seen in 66.67%, LVI in 34.78%, PNI in 37.68%, 52.17% had inguinal node involvement with pN3 being the most common (36.23%), and 36.23% had ENE. Kaplan-Meier analysis revealed that NLR of >3 and the LMR ≤3 indicated an inferior CSS (P = 0.05 and 0.04, respectively). T stage, inguinal node involvement, LVI, pN stage, and ENE were also associated with inferior CSS (P < 0.05). On multivariate analysis, T stage was significantly associated with CSS (P = 0.02). The NLR >3 and LMR ≤3 were also significantly associated with the presence of pathological inguinal node involvement (P = 0.001 and 0.026). Conclusion: NLR and LMR may help in predicting CSS and inguinal node involvement in patients of carcinoma penis.