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Article

High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma

  • Authors:
    • Kiyoaki Nishihara
    • Shigetaka Suekane
    • Kousuke Ueda
    • Makoto Nakiri
    • Mitsunori Matsuo
    • Tsukasa Igawa
  • View Affiliations / Copyright

    Affiliations: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
  • Pages: 5241-5250
    |
    Published online on: March 21, 2019
       https://doi.org/10.3892/ol.2019.10178
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Abstract

Previously, the preoperative neutrophil‑to‑lymphocyte ratio (NLR) has been demonstrated to be a beneficial prognostic marker in patients with upper tract urothelial carcinoma (UTUC). However, to the best of our knowledge, the postoperative NLR has rarely been investigated. Therefore, the present study evaluated the prognostic significance of postoperative NLR in patients with UTUC. Data of patients with UTUC who underwent surgical treatment at Kurume University hospital (Kurume, Japan) between 2004 and 2015 were retrospectively reviewed. Clinicopathological characteristics were analyzed, including pre‑ and postoperative NLRs. Overall survival (OS) and cancer‑specific survival (CSS) rates were estimated using the Kaplan‑Meier method and compared with a log‑rank test. Multivariate proportional Cox regression models were applied for both endpoints to identify the independent prognostic significance of NLR. The median age of the 134 enrolled patients was 70 years. The postoperative NLR was elevated in 35 patients (26.1%). A high postoperative NLR of ≥2.5 was significantly associated with a high postoperative C‑reactive protein level of ≥0.3 mg/dl, an advanced pathological T stage and positive lymphovascular invasion in surgical specimens (P<0.001, P=0.019 and P=0.024, respectively). The 5‑year OS rates in patients with high and low postoperative NLR were 33.7 and 70.2%, respectively (P<0.001), and the 5‑year CSS rates in patients with a high and low postoperative NLR were 33.7 and 80.7%, respectively (P<0.001). Multivariate analysis revealed that a high postoperative NLR was an independent prognostic marker for OS (hazard ratio, 4.66; 95% confidence interval, 2.11‑10.00; P<0.001) and CSS (hazard ratio, 10.90; 95% confidence interval, 4.32‑28.40; P<0.001), and the preoperative NLR was not identified as a prognostic marker. In conclusion, a high postoperative NLR is associated with a poor prognosis in patients with UTUC. Therefore, postoperative NLR may be a potential prognostic marker in patients with UTUC undergoing nephroureterectomy.
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Copy and paste a formatted citation
Spandidos Publications style
Nishihara K, Suekane S, Ueda K, Nakiri M, Matsuo M and Igawa T: High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma. Oncol Lett 17: 5241-5250, 2019.
APA
Nishihara, K., Suekane, S., Ueda, K., Nakiri, M., Matsuo, M., & Igawa, T. (2019). High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma. Oncology Letters, 17, 5241-5250. https://doi.org/10.3892/ol.2019.10178
MLA
Nishihara, K., Suekane, S., Ueda, K., Nakiri, M., Matsuo, M., Igawa, T."High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma". Oncology Letters 17.6 (2019): 5241-5250.
Chicago
Nishihara, K., Suekane, S., Ueda, K., Nakiri, M., Matsuo, M., Igawa, T."High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma". Oncology Letters 17, no. 6 (2019): 5241-5250. https://doi.org/10.3892/ol.2019.10178
Copy and paste a formatted citation
x
Spandidos Publications style
Nishihara K, Suekane S, Ueda K, Nakiri M, Matsuo M and Igawa T: High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma. Oncol Lett 17: 5241-5250, 2019.
APA
Nishihara, K., Suekane, S., Ueda, K., Nakiri, M., Matsuo, M., & Igawa, T. (2019). High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma. Oncology Letters, 17, 5241-5250. https://doi.org/10.3892/ol.2019.10178
MLA
Nishihara, K., Suekane, S., Ueda, K., Nakiri, M., Matsuo, M., Igawa, T."High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma". Oncology Letters 17.6 (2019): 5241-5250.
Chicago
Nishihara, K., Suekane, S., Ueda, K., Nakiri, M., Matsuo, M., Igawa, T."High postoperative neutrophil‑to‑lymphocyte ratio as a poor prognostic marker in patients with upper tract urothelial carcinoma". Oncology Letters 17, no. 6 (2019): 5241-5250. https://doi.org/10.3892/ol.2019.10178
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