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Combination of the Preoperative Systemic Immune-Inflammation Index and Monocyte-Lymphocyte Ratio as a Novel Prognostic Factor in Patients with Upper-Tract Urothelial Carcinoma

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to evaluate the clinical significance of the preoperative systemic immune-inflammation index (SII) combined with the monocyte-lymphocyte ratio (MLR) for patients with upper-tract urothelial carcinoma (UTUC).

Methods

The clinical data of 424 patients who underwent radical nephroureterectomy from January 2007 to June 2017 were analyzed. Kaplan–Meier analyses and Cox proportional hazards models were used to evaluate associations of preoperative systemic immune-inflammatory biomarkers with overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). Moreover, logistic regression preoperative models were applied to predict advanced disease.

Results

Multivariate analyses showed that SII significantly influenced both OS and CSS (both P < 0.05), whereas MLR exhibited the most significant association with OS (P = 0.008). In particular, simultaneously high SII and MLR values correlated significantly with OS, CSS, and PFS (all P < 0.05). Logistic regression preoperative models showed that the combination of high SII and high MLR was a significant predictor of non-organ-confined UTUC (P = 0.001). Furthermore, Kaplan–Meier analysis showed that the combination of high SII and high MLR was significantly linked with poor OS, CSS, and PFS in non-organ-confined UTUC (all P < 0.05).

Conclusion

The study reviewed serum inflammation biomarkers in a subset of patients with UTUC and demonstrated the ability of combined SII and MLR to predict disease progression and survival. Patients with both high SII and high MLR were significantly more likely to have non-organ-confined disease and poor survival outcomes.

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Authors and Affiliations

  1. Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan

    Hau-Chern Jan MD, Wen-Horng Yang MD & Chien-Hui Ou MD

  2. Department of Urology, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Wen-Horng Yang MD & Chien-Hui Ou MD

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  1. Hau-Chern Jan MD
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Correspondence to Chien-Hui Ou MD.

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The article does not contain any studies involving human participants or animals performed by any of the authors. Formal consent is not required for this retrospective type of study.

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Jan, HC., Yang, WH. & Ou, CH. Combination of the Preoperative Systemic Immune-Inflammation Index and Monocyte-Lymphocyte Ratio as a Novel Prognostic Factor in Patients with Upper-Tract Urothelial Carcinoma. Ann Surg Oncol 26, 669–684 (2019). https://doi.org/10.1245/s10434-018-6942-3

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