Pretreatment neutrophil-to-lymphocyte ratio as an independent predictor of survival in patients with metastatic urothelial carcinoma: A multi-institutional study

Objectives To evaluate the prognostic significance of the pretreatment neutrophil‐to‐lymphocyte ratio in patients with metastatic urothelial carcinoma who underwent salvage chemotherapy. Methods We reviewed 200 metastatic urothelial carcinoma patients who received salvage chemotherapy at our five af...

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Bibliographic Details
Published in:International journal of urology 2015-07, Vol.22 (7), p.638-643
Main Authors: Taguchi, Satoru, Nakagawa, Tohru, Matsumoto, Akihiko, Nagase, Yasushi, Kawai, Taketo, Tanaka, Yoshinori, Yoshida, Kanae, Yamamoto, Sachi, Enomoto, Yutaka, Nose, Yorito, Sato, Toshikazu, Ishikawa, Akira, Uemura, Yukari, Fujimura, Tetsuya, Fukuhara, Hiroshi, Kume, Haruki, Homma, Yukio
Format: Article
Language:English
Subjects:
Aged
bladder cancer
Carcinoma, Transitional Cell - pathology
Carcinoma, Transitional Cell - therapy
chemotherapy
Female
Humans
Kaplan-Meier Estimate
Lymphocyte Count
Male
metastatic
Middle Aged
Multivariate Analysis
Neoplasm Metastasis - diagnosis
neutrophil-to-lymphocyte ratio
Neutrophils - cytology
Prognosis
Proportional Hazards Models
Retrospective Studies
Salvage Therapy
Urologic Neoplasms - pathology
Urologic Neoplasms - therapy
urothelial carcinoma
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Summary:Objectives To evaluate the prognostic significance of the pretreatment neutrophil‐to‐lymphocyte ratio in patients with metastatic urothelial carcinoma who underwent salvage chemotherapy. Methods We reviewed 200 metastatic urothelial carcinoma patients who received salvage chemotherapy at our five affiliate institutions between 2003 and 2011. The associations of pretreatment clinicopathological factors, including neutrophil‐to‐lymphocyte ratio, with cancer‐specific survival and overall survival from the start of chemotherapy were assessed. Cox proportional hazards model was used for multivariate analysis. Results A total of 15 cases with missing data were excluded. Among the remaining 185 patients, 157 died during follow up, with a median survival of 13.0 months. Multivariate analysis showed that the pretreatment neutrophil‐to‐lymphocyte ratio ≥3, Eastern Cooperative Oncology Group performance status ≥2 and liver metastasis were independent poor prognostic factors, both for cancer‐specific survival and overall survival. A prognostic model predicting overall survival was constructed based on the number of these three variables (0, 1 and ≥ 2). The classified patients showed significantly different overall survival (each P 
ISSN:0919-8172
1442-2042
DOI:10.1111/iju.12766