Study of pre-operative neutrophil–lymphocyte ratio in urothelial carcinoma

Kausalya Kumari Sahu; Madhurya Ramineni; Pooja K. Suresh; Jyoti R. Kini; Flora D. Lobo

doi:10.1515/jbcpp-2020-0276

Article

Study of pre-operative neutrophil–lymphocyte ratio in urothelial carcinoma

Kausalya Kumari Sahu , Madhurya Ramineni , Pooja K. Suresh , Jyoti R. Kini and Flora D. Lobo

Published/Copyright: June 21, 2021

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From the journal Journal of Basic and Clinical Physiology and Pharmacology Volume 34 Issue 4

Abstract

Objectives

Neutrophil–lymphocyte ratio (NLR), as an indicator of heightened systemic inflammatory response, predicts increased disease burden and poor oncological outcomes in urothelial carcinoma (UC). The study was undertaken with an aim to evaluate the association of NLR with clinicopathological variables and survival outcomes.

Methods

A total of 80 patients of UC were enrolled in the current retrospective study. Pre-operative NLR (within one month prior to the procedure), patient age, sex, tumour grade, pathological stage, recurrence free survival (RFS), progression free survival (PFS) and cancer specific survival (CSS) were recorded. We chose a cut-off value of 2.7 for NLR and patients were divide into two groups (NLR <2.7 and ≥2.7).

Results

NLR ≥2.7 was significantly associated with advanced tumour stage (p=0.001), but not with tumour grade (p=0.116). Progression (p=0.032) and death rates (p=0.026) were high in patients with NLR ≥2.7. Mean RFS (p=0.03), PFS (p=0.04) and CSS (p=0.04) were reduced in patients with NLR ≥2.7. On univariate analysis, NLR ≥2.7 predicted worse RFS (HR=2.928, p=0.007), PFS (HR=3.180, p=0.006) and CSS (HR=3.109, p=0.016). However, it was not an independent predictor of outcomes on multivariate analysis.

Conclusions

Tumour stage and grade are the only independent predictors of RFS, PFS and CSS. High NLR at a cut-off value of ≥2.7 is associated with advanced pathological stage, but does not have an independent predictive value for RFS, PFS and CSS.

Keywords: cancer specific survival; neutrophil–lymphocyte ratio; progression free survival; recurrence free survival; urothelial carcinoma

Corresponding author: Madhurya Ramineni, MD, Junior Resident, Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Light House Hill Road, 575003 Mangalore, Karnataka, India, Phone: 8500425810, E-mail: madhurya1198@gmail.com

Research funding: None.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was not obtained as the study was done on the archival data obtained from the pathology department.
Ethical approval: The retrospective study was conducted after obtaining the institutional ethics committee clearance.

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Received: 2020-09-30

Accepted: 2021-04-15

Published Online: 2021-06-21

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Articles in the same Issue

https://doi.org/10.1515/jbcpp-2020-0276

Keywords for this article

cancer specific survival; neutrophil–lymphocyte ratio; progression free survival; recurrence free survival; urothelial carcinoma