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Association between early change in neutrophil‐to‐lymphocyte ratio after radical cystectomy and treatment outcomes
Objectives To evaluate the associations of peri‐operative neutrophil‐to‐lymphocyte ratio (NLR) and change in NLR with survival after radical cystectomy. Patients and Methods We retrospectively reviewed a multicentre cohort of patients with bladder cancer who underwent radical cystectomy between 2010...
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| Published in: | BJU international 2022-10, Vol.130 (4), p.470-477 |
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| creator | Herzberg, Haim Lifshitz, Karin Golan, Shay Baniel, Jack Malshy, Kamil Hoffman, Azik Amiel, Gilad E. Zreik, Rani Freifeld, Yuval Dekel, Yoram Lasmanovich, Rinat Lazarovich, Alon Rosenzweig, Barak Dotan, Zohar Yossepowitch, Ofer Mano, Roy |
| description | Objectives
To evaluate the associations of peri‐operative neutrophil‐to‐lymphocyte ratio (NLR) and change in NLR with survival after radical cystectomy.
Patients and Methods
We retrospectively reviewed a multicentre cohort of patients with bladder cancer who underwent radical cystectomy between 2010 and 2020. Preoperative NLR, postoperative NLR, delta‐NLR (postoperative minus preoperative NLR) and NLR change (postoperative divided by preoperative NLR) were calculated. Patients were stratified based on elevation of preoperative and/ or postoperative NLR above the median values. Multivariable Cox regression models were used to evaluate the associations of peri‐operative NLR and NLR change with survival.
Results
The study cohort included 346 patients with a median age of 69 years. The median (interquartile range) preoperative NLR, postoperative NLR, delta‐NLR and NLR change were 2.55 (1.83, 3.90), 3.33 (2.21, 5.20), 0.43 (−0.50, 2.08) and 1.2 (0.82, 1.96), respectively. Both preoperative and postoperative NLR were elevated in 110 patients (32%), 126 patients (36%) had an elevated preoperative or postoperative NLR, and 110 patients (32%) did not have an elevated NLR. On multivariable analysis, increased preoperative and postoperative NLR were significantly associated with decreased survival. While delta‐NLR and NLR change were not associated with outcome, patients with elevations in both preoperative and postoperative NLR had the worst overall (hazard ratio [HR] 2.97, 95% confidence interval [CI] 1.78, 4.95; P |
| doi_str_mv | 10.1111/bju.15757 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2656743022</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2713982430</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3187-acaa3aeb5e5e4e88514d177f1c8f4c077f197888918a5653d0a4bcf676f9ff9f3</originalsourceid><addsrcrecordid>eNp1kc1KJDEUhYMo6qgLX2AIuHEWrUlV_mqpos6IMJsR3IVU6tZ0NVVJm6SU2vkIPuM8ielpdSF4CfcewncPIQehQ0pOaK7TejGeUC653EC7lAk2Y5Tcb75rUokd9C3GBSH5QvBttFNyJoWq-C56PIvR286kzjtcQ3oCcBhM6Cds58b9Bdw57GBMwS_nXf_v-SX53PppWM69nRLgsNrFpk0Qsm46a3psp5jAJj9M2LgGpwAmDeAS9mOyfoC4j7Za00c4eJt76O7q8s_Fz9nt7-tfF2e3M1tSJWfGGlMaqDlwYKAUp6yhUrbUqpZZslKVVEpVVBkueNkQw2rbCinaqs2n3EPHa99l8A8jxKSHLlroe-PAj1EXggvJSlIUGT36hC78GFx-nS4kLStVZC5TP9aUDT7GAK1ehm4wYdKU6FUYOoeh_4eR2e9vjmM9QPNBvv9-Bk7XwFPXw_S1kz6_uVtbvgIYYJgG</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2713982430</pqid></control><display><type>article</type><title>Association between early change in neutrophil‐to‐lymphocyte ratio after radical cystectomy and treatment outcomes</title><source>Wiley</source><creator>Herzberg, Haim ; Lifshitz, Karin ; Golan, Shay ; Baniel, Jack ; Malshy, Kamil ; Hoffman, Azik ; Amiel, Gilad E. ; Zreik, Rani ; Freifeld, Yuval ; Dekel, Yoram ; Lasmanovich, Rinat ; Lazarovich, Alon ; Rosenzweig, Barak ; Dotan, Zohar ; Yossepowitch, Ofer ; Mano, Roy</creator><creatorcontrib>Herzberg, Haim ; Lifshitz, Karin ; Golan, Shay ; Baniel, Jack ; Malshy, Kamil ; Hoffman, Azik ; Amiel, Gilad E. ; Zreik, Rani ; Freifeld, Yuval ; Dekel, Yoram ; Lasmanovich, Rinat ; Lazarovich, Alon ; Rosenzweig, Barak ; Dotan, Zohar ; Yossepowitch, Ofer ; Mano, Roy</creatorcontrib><description>Objectives
To evaluate the associations of peri‐operative neutrophil‐to‐lymphocyte ratio (NLR) and change in NLR with survival after radical cystectomy.
Patients and Methods
We retrospectively reviewed a multicentre cohort of patients with bladder cancer who underwent radical cystectomy between 2010 and 2020. Preoperative NLR, postoperative NLR, delta‐NLR (postoperative minus preoperative NLR) and NLR change (postoperative divided by preoperative NLR) were calculated. Patients were stratified based on elevation of preoperative and/ or postoperative NLR above the median values. Multivariable Cox regression models were used to evaluate the associations of peri‐operative NLR and NLR change with survival.
Results
The study cohort included 346 patients with a median age of 69 years. The median (interquartile range) preoperative NLR, postoperative NLR, delta‐NLR and NLR change were 2.55 (1.83, 3.90), 3.33 (2.21, 5.20), 0.43 (−0.50, 2.08) and 1.2 (0.82, 1.96), respectively. Both preoperative and postoperative NLR were elevated in 110 patients (32%), 126 patients (36%) had an elevated preoperative or postoperative NLR, and 110 patients (32%) did not have an elevated NLR. On multivariable analysis, increased preoperative and postoperative NLR were significantly associated with decreased survival. While delta‐NLR and NLR change were not associated with outcome, patients with elevations in both preoperative and postoperative NLR had the worst overall (hazard ratio [HR] 2.97, 95% confidence interval [CI] 1.78, 4.95; P < 0.001) and cancer‐specific survival rates (HR 2.41, 95% CI 1.3, 4.4; P = 0.004).
Conclusions
Preoperative and postoperative NLR are significant predictors of survival after radical cystectomy; patients in whom both NLR measures were elevated had the worst outcomes. Future studies should evaluate whether an increase in NLR during long‐term follow‐up may precede disease recurrence.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.15757</identifier><identifier>PMID: 35476895</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Bladder cancer ; BladderCancer ; blcsm ; Leukocytes (neutrophilic) ; Lymphocytes ; Neutrophils ; neutrophil‐lymphocyte‐ratio ; Patients ; prognosis ; radical cystectomy ; Regression analysis ; survival ; uroonc</subject><ispartof>BJU international, 2022-10, Vol.130 (4), p.470-477</ispartof><rights>2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3187-acaa3aeb5e5e4e88514d177f1c8f4c077f197888918a5653d0a4bcf676f9ff9f3</citedby><cites>FETCH-LOGICAL-c3187-acaa3aeb5e5e4e88514d177f1c8f4c077f197888918a5653d0a4bcf676f9ff9f3</cites><orcidid>0000-0002-3824-5148 ; 0000-0002-5668-1330 ; 0000-0003-3855-0211 ; 0000-0002-9205-5820 ; 0000-0002-7521-5319</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35476895$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Herzberg, Haim</creatorcontrib><creatorcontrib>Lifshitz, Karin</creatorcontrib><creatorcontrib>Golan, Shay</creatorcontrib><creatorcontrib>Baniel, Jack</creatorcontrib><creatorcontrib>Malshy, Kamil</creatorcontrib><creatorcontrib>Hoffman, Azik</creatorcontrib><creatorcontrib>Amiel, Gilad E.</creatorcontrib><creatorcontrib>Zreik, Rani</creatorcontrib><creatorcontrib>Freifeld, Yuval</creatorcontrib><creatorcontrib>Dekel, Yoram</creatorcontrib><creatorcontrib>Lasmanovich, Rinat</creatorcontrib><creatorcontrib>Lazarovich, Alon</creatorcontrib><creatorcontrib>Rosenzweig, Barak</creatorcontrib><creatorcontrib>Dotan, Zohar</creatorcontrib><creatorcontrib>Yossepowitch, Ofer</creatorcontrib><creatorcontrib>Mano, Roy</creatorcontrib><title>Association between early change in neutrophil‐to‐lymphocyte ratio after radical cystectomy and treatment outcomes</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objectives
To evaluate the associations of peri‐operative neutrophil‐to‐lymphocyte ratio (NLR) and change in NLR with survival after radical cystectomy.
Patients and Methods
We retrospectively reviewed a multicentre cohort of patients with bladder cancer who underwent radical cystectomy between 2010 and 2020. Preoperative NLR, postoperative NLR, delta‐NLR (postoperative minus preoperative NLR) and NLR change (postoperative divided by preoperative NLR) were calculated. Patients were stratified based on elevation of preoperative and/ or postoperative NLR above the median values. Multivariable Cox regression models were used to evaluate the associations of peri‐operative NLR and NLR change with survival.
Results
The study cohort included 346 patients with a median age of 69 years. The median (interquartile range) preoperative NLR, postoperative NLR, delta‐NLR and NLR change were 2.55 (1.83, 3.90), 3.33 (2.21, 5.20), 0.43 (−0.50, 2.08) and 1.2 (0.82, 1.96), respectively. Both preoperative and postoperative NLR were elevated in 110 patients (32%), 126 patients (36%) had an elevated preoperative or postoperative NLR, and 110 patients (32%) did not have an elevated NLR. On multivariable analysis, increased preoperative and postoperative NLR were significantly associated with decreased survival. While delta‐NLR and NLR change were not associated with outcome, patients with elevations in both preoperative and postoperative NLR had the worst overall (hazard ratio [HR] 2.97, 95% confidence interval [CI] 1.78, 4.95; P < 0.001) and cancer‐specific survival rates (HR 2.41, 95% CI 1.3, 4.4; P = 0.004).
Conclusions
Preoperative and postoperative NLR are significant predictors of survival after radical cystectomy; patients in whom both NLR measures were elevated had the worst outcomes. Future studies should evaluate whether an increase in NLR during long‐term follow‐up may precede disease recurrence.</description><subject>Bladder cancer</subject><subject>BladderCancer</subject><subject>blcsm</subject><subject>Leukocytes (neutrophilic)</subject><subject>Lymphocytes</subject><subject>Neutrophils</subject><subject>neutrophil‐lymphocyte‐ratio</subject><subject>Patients</subject><subject>prognosis</subject><subject>radical cystectomy</subject><subject>Regression analysis</subject><subject>survival</subject><subject>uroonc</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kc1KJDEUhYMo6qgLX2AIuHEWrUlV_mqpos6IMJsR3IVU6tZ0NVVJm6SU2vkIPuM8ielpdSF4CfcewncPIQehQ0pOaK7TejGeUC653EC7lAk2Y5Tcb75rUokd9C3GBSH5QvBttFNyJoWq-C56PIvR286kzjtcQ3oCcBhM6Cds58b9Bdw57GBMwS_nXf_v-SX53PppWM69nRLgsNrFpk0Qsm46a3psp5jAJj9M2LgGpwAmDeAS9mOyfoC4j7Za00c4eJt76O7q8s_Fz9nt7-tfF2e3M1tSJWfGGlMaqDlwYKAUp6yhUrbUqpZZslKVVEpVVBkueNkQw2rbCinaqs2n3EPHa99l8A8jxKSHLlroe-PAj1EXggvJSlIUGT36hC78GFx-nS4kLStVZC5TP9aUDT7GAK1ehm4wYdKU6FUYOoeh_4eR2e9vjmM9QPNBvv9-Bk7XwFPXw_S1kz6_uVtbvgIYYJgG</recordid><startdate>202210</startdate><enddate>202210</enddate><creator>Herzberg, Haim</creator><creator>Lifshitz, Karin</creator><creator>Golan, Shay</creator><creator>Baniel, Jack</creator><creator>Malshy, Kamil</creator><creator>Hoffman, Azik</creator><creator>Amiel, Gilad E.</creator><creator>Zreik, Rani</creator><creator>Freifeld, Yuval</creator><creator>Dekel, Yoram</creator><creator>Lasmanovich, Rinat</creator><creator>Lazarovich, Alon</creator><creator>Rosenzweig, Barak</creator><creator>Dotan, Zohar</creator><creator>Yossepowitch, Ofer</creator><creator>Mano, Roy</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3824-5148</orcidid><orcidid>https://orcid.org/0000-0002-5668-1330</orcidid><orcidid>https://orcid.org/0000-0003-3855-0211</orcidid><orcidid>https://orcid.org/0000-0002-9205-5820</orcidid><orcidid>https://orcid.org/0000-0002-7521-5319</orcidid></search><sort><creationdate>202210</creationdate><title>Association between early change in neutrophil‐to‐lymphocyte ratio after radical cystectomy and treatment outcomes</title><author>Herzberg, Haim ; Lifshitz, Karin ; Golan, Shay ; Baniel, Jack ; Malshy, Kamil ; Hoffman, Azik ; Amiel, Gilad E. ; Zreik, Rani ; Freifeld, Yuval ; Dekel, Yoram ; Lasmanovich, Rinat ; Lazarovich, Alon ; Rosenzweig, Barak ; Dotan, Zohar ; Yossepowitch, Ofer ; Mano, Roy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3187-acaa3aeb5e5e4e88514d177f1c8f4c077f197888918a5653d0a4bcf676f9ff9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Bladder cancer</topic><topic>BladderCancer</topic><topic>blcsm</topic><topic>Leukocytes (neutrophilic)</topic><topic>Lymphocytes</topic><topic>Neutrophils</topic><topic>neutrophil‐lymphocyte‐ratio</topic><topic>Patients</topic><topic>prognosis</topic><topic>radical cystectomy</topic><topic>Regression analysis</topic><topic>survival</topic><topic>uroonc</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Herzberg, Haim</creatorcontrib><creatorcontrib>Lifshitz, Karin</creatorcontrib><creatorcontrib>Golan, Shay</creatorcontrib><creatorcontrib>Baniel, Jack</creatorcontrib><creatorcontrib>Malshy, Kamil</creatorcontrib><creatorcontrib>Hoffman, Azik</creatorcontrib><creatorcontrib>Amiel, Gilad E.</creatorcontrib><creatorcontrib>Zreik, Rani</creatorcontrib><creatorcontrib>Freifeld, Yuval</creatorcontrib><creatorcontrib>Dekel, Yoram</creatorcontrib><creatorcontrib>Lasmanovich, Rinat</creatorcontrib><creatorcontrib>Lazarovich, Alon</creatorcontrib><creatorcontrib>Rosenzweig, Barak</creatorcontrib><creatorcontrib>Dotan, Zohar</creatorcontrib><creatorcontrib>Yossepowitch, Ofer</creatorcontrib><creatorcontrib>Mano, Roy</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley-Blackwell Backfiles (Open access)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Herzberg, Haim</au><au>Lifshitz, Karin</au><au>Golan, Shay</au><au>Baniel, Jack</au><au>Malshy, Kamil</au><au>Hoffman, Azik</au><au>Amiel, Gilad E.</au><au>Zreik, Rani</au><au>Freifeld, Yuval</au><au>Dekel, Yoram</au><au>Lasmanovich, Rinat</au><au>Lazarovich, Alon</au><au>Rosenzweig, Barak</au><au>Dotan, Zohar</au><au>Yossepowitch, Ofer</au><au>Mano, Roy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between early change in neutrophil‐to‐lymphocyte ratio after radical cystectomy and treatment outcomes</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2022-10</date><risdate>2022</risdate><volume>130</volume><issue>4</issue><spage>470</spage><epage>477</epage><pages>470-477</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objectives
To evaluate the associations of peri‐operative neutrophil‐to‐lymphocyte ratio (NLR) and change in NLR with survival after radical cystectomy.
Patients and Methods
We retrospectively reviewed a multicentre cohort of patients with bladder cancer who underwent radical cystectomy between 2010 and 2020. Preoperative NLR, postoperative NLR, delta‐NLR (postoperative minus preoperative NLR) and NLR change (postoperative divided by preoperative NLR) were calculated. Patients were stratified based on elevation of preoperative and/ or postoperative NLR above the median values. Multivariable Cox regression models were used to evaluate the associations of peri‐operative NLR and NLR change with survival.
Results
The study cohort included 346 patients with a median age of 69 years. The median (interquartile range) preoperative NLR, postoperative NLR, delta‐NLR and NLR change were 2.55 (1.83, 3.90), 3.33 (2.21, 5.20), 0.43 (−0.50, 2.08) and 1.2 (0.82, 1.96), respectively. Both preoperative and postoperative NLR were elevated in 110 patients (32%), 126 patients (36%) had an elevated preoperative or postoperative NLR, and 110 patients (32%) did not have an elevated NLR. On multivariable analysis, increased preoperative and postoperative NLR were significantly associated with decreased survival. While delta‐NLR and NLR change were not associated with outcome, patients with elevations in both preoperative and postoperative NLR had the worst overall (hazard ratio [HR] 2.97, 95% confidence interval [CI] 1.78, 4.95; P < 0.001) and cancer‐specific survival rates (HR 2.41, 95% CI 1.3, 4.4; P = 0.004).
Conclusions
Preoperative and postoperative NLR are significant predictors of survival after radical cystectomy; patients in whom both NLR measures were elevated had the worst outcomes. Future studies should evaluate whether an increase in NLR during long‐term follow‐up may precede disease recurrence.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35476895</pmid><doi>10.1111/bju.15757</doi><tpages>477</tpages><orcidid>https://orcid.org/0000-0002-3824-5148</orcidid><orcidid>https://orcid.org/0000-0002-5668-1330</orcidid><orcidid>https://orcid.org/0000-0003-3855-0211</orcidid><orcidid>https://orcid.org/0000-0002-9205-5820</orcidid><orcidid>https://orcid.org/0000-0002-7521-5319</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bladder cancer BladderCancer blcsm Leukocytes (neutrophilic) Lymphocytes Neutrophils neutrophil‐lymphocyte‐ratio Patients prognosis radical cystectomy Regression analysis survival uroonc |
| title | Association between early change in neutrophil‐to‐lymphocyte ratio after radical cystectomy and treatment outcomes |
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