Preoperative lymphocyte-monocyte and platelet-lymphocyte ratios as predictors of overall survival in patients with bladder cancer undergoing radical cystectomy
Although pretreatment neutrophil–lymphocyte ratio (NLR), lymphocyte–monocyte ratio (LMR), and platelet–lymphocyte ratio (PLR) are reportedly associated with clinical outcomes of many cancers, their roles in patients with bladder cancer (BCa) who undergo radical cystectomy (RC) have not been widely investigated. We analyzed relationships between preoperative NLR, LMR, PLR, and overall survival (OS) in 124 BCa patients undergoing RC. OS curves were drawn using the Kaplan–Meier method and evaluated using the log-rank test. Relationships between OS and potential confounding variables were determined using Cox’s proportional hazard regression model. Decreased LMR was associated with shorter OS (P = 0.012); OS in the low PLR group was significantly longer than that in the high PLR group (P = 0.029), and NLR was not significantly associated with oncological outcomes. However, after adjusting for confounding variables, patients in the high-LMR group indicated >30 % decreased mortality than the low-LMR group (hazard ratio 0.674; 95 % confidence interval 0.412–0.890; P = 0.003), and PLR was not an independent predictor of OS. Our results show that preoperative LMR is a better prognostic factor in BCa patients undergoing RC, compared with NLR and PLR.
KeywordsBladder cancer Radical cystectomy Prognosis NLR LMR PLR
- 14.Kilincalp S, Coban S, Akinci H, Hamamc M, Karaahmet F, Coskun Y, et al. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and mean platelet volume as potential biomarkers for early detection and monitoring of colorectal adenocarcinoma. Eur J Cancer Prev. 2015;24:328–33.CrossRefPubMedGoogle Scholar
- 18.Viers BR, Boorjian SA, Frank I, Tarrell RF, Thapa P, Karnes RJ, et al. Pretreatment neutrophil-to-lymphocyte ratio is associated with advanced pathologic tumor stage and increased cancer-specific mortality among patients with urothelial carcinoma of the bladder undergoing radical cystectomy. Eur Urol. 2014;66:1157–64.CrossRefPubMedGoogle Scholar
- 19.Temraz S, Mukherji D, Farhat ZA, Nasr R, Charafeddine M, Shahait M, et al. Preoperative lymphocyte-to-monocyte ratio predicts clinical outcome in patients undergoing radical cystectomy for transitional cell carcinoma of the bladder: a retrospective analysis. BMC Urol. 2014;14:76.CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Rothwell PM, Price JF, Fowkes FG, Zanchetti A, Roncaglioni MC, Tognoni G, et al. Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet. 2012;379:1602–12.CrossRefPubMedGoogle Scholar
- 32.Clifton MM, Psutka SP, Boorjian SA, Cheville JC, Thapa P, Thompson RH, et al. Cancer-specific mortality following radical cystectomy for bladder cancer with lymph node involvement: impact of pathologic disease features and adjuvant chemotherapy. World J Urol. 2015;33:373–9.CrossRefPubMedGoogle Scholar