TY - JOUR AB - The present study aimed to evaluate the influence of pre‑treatment neutrophil‑to‑lymphocyte ratio (NLR) on bladder recurrence in patients with impaired renal function following radical nephrouretectomy (RNU) to treat pure upper tract urothelial carcinoma (UTUC). Retrospective data of 362 patients with pure UTUC who underwent RNU between 2008 and 2019 were analyzed. Kaplan‑Meier analyses were performed to evaluate the association of preoperative NLR and estimation of the glomerular filtration rate (eGFR) with intravesical recurrence‑free survival (IVRF). Furthermore, multivariate analyses were conducted to determine independent factors for predicting IVRF. In the retrospective cohort study of 362 patients, 103 patients (28%) had intravesical recurrence in a median follow‑up of 50.1 months; among those, 85 (83%) developed bladder recurrence within two years after RNU. The Kaplan‑Meier analysis indicated that patients exhibiting lower eGFR and higher NLR showed significantly poor IVRF rates (P=0.044). The simultaneous presence of eGFR <45 and NLR >3.8 was an independent factor for the shorter IVRF time in multivariate analysis with Cox's proportional hazards model. Most intravesical recurrences occurred within two years after RNU, particularly in pre‑existing poor eGFR patients with preoperative high NLR. Moreover, pre‑existing moderate to severe CKD synchronous with pre‑operative NLR >3.8 was demonstrated as an independent factor for subsequent bladder recurrence in patients with pure UTUC following RNU. Therefore, such high‑risk patients ought to be provided with close bladder monitoring during the follow‑up. AD - Department of Urology, National Cheng Kung University Hospital, Tainan 70403, Taiwan, R.O.C AU - Cheng,Tsung-Han AU - Hu,Che-Yuan AU - Wu,Kuan-Yu AU - Tai,Ta-Yao AU - Weng,Han-Yu AU - Yang,Wen-Horng AU - Ou,Chien-Hui AU - Jan,Hau-Chern AU - Cheng,Tsung-Han AU - Hu,Che-Yuan AU - Wu,Kuan-Yu AU - Tai,Ta-Yao AU - Weng,Han-Yu AU - Yang,Wen-Horng AU - Ou,Chien-Hui AU - Jan,Hau-Chern DA - 2022/11/01 DO - 10.3892/etm.2022.11606 IS - 5 JO - Exp Ther Med KW - glomerular filtration rate neutrophil‑to‑lymphocyte ratio renal insufficiency bladder recurrence intravesival recurrence upper tract urothelial carcinoma PY - 2022 SN - 1792-0981 1792-1015 SP - 671 ST - Pre‑existing renal insufficiency synchronous with high preoperative neutrophil‑to‑lymphocyte ratio as a risk factor of intravesical recurrence in patients with pure upper tract urothelial carcinoma after radical nephroureterectomy T2 - Experimental and Therapeutic Medicine TI - Pre‑existing renal insufficiency synchronous with high preoperative neutrophil‑to‑lymphocyte ratio as a risk factor of intravesical recurrence in patients with pure upper tract urothelial carcinoma after radical nephroureterectomy UR - https://doi.org/10.3892/etm.2022.11606 VL - 24 ER -