International Journal of Clinical Oncology

, Volume 22, Issue 5, pp 964–971 | Cite as

A critical prognostic analysis of neutrophil–lymphocyte ratio for patients undergoing nephroureterectomy due to upper urinary tract urothelial carcinoma

  • Mesut Altan
  • Hakan Bahadır HaberalEmail author
  • Bülent Akdoğan
  • Haluk Özen
Original Article



To determine preoperative serum complete blood count parameters that affects survival of patients who underwent surgery for upper urinary tract urothelial cancer (UUT-UC).


Since 1990, 150 patients underwent nephroureterectomy with bladder cuff excision for UUT-UC at Hacettepe University. Patients with a history of muscle-invasive bladder cancer, adjuvant chemotherapy or metastasis at the time of diagnosis were excluded. One hundred and thirteen patients without infective symptoms and with a full set of serum data were evaluated retrospectively. Effects of the neutrophil–lymphocyte ratio (NLR), lymphocyte–monocyte ratio (LMR), platelet–lymphocyte ratio (PLR), and leukocyte count on disease-free survival (DFS) and progression-free survival (PFS) were investigated. Threshold values for each parameter to predict PFS were calculated.


The mean age and median follow-up were 63.7 ± 11.1 years and 34 (3–186) months, respectively. Male to female ratio was 86/27. The 5-years PFS (bladder recurrence was excluded) and DFS were 59.6 and 38.4%, respectively. In multivariate analysis, NLR was independent prognostic factor for PFS and DFS (p = 0.006 and p = 0.021, respectively) while LMR was prognostic only for PFS (p = 0.037).


For UUT-UC, NLR is a prognostic factor for PFS and DFS, while LMR is a prognostic indicator for PFS in present series.


Upper urinary tract Urothelial carcinoma Neutrophil–lymphocyte ratio Complete blood count parameters Progression free survival 


Compliance with ethical standards

Conflict of interest

The author declares that they have no conflict on interest


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Copyright information

© Japan Society of Clinical Oncology 2017

Authors and Affiliations

  1. 1.Department of UrologyHacettepe University School of MedicineAnkaraTurkey

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