Prognostic values of preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and lymphocyte-to-monocyte ratio for patients with muscle-invasive bladder cancer undergoing radical cystectomy / Prognostic values of preoperative neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and lymphocyte- to-monocyte ratio for patients with muscle- invasive bladder cancer undergoing radical cystectomy

ABSTRACT

OBJECTIVE: To study the prognostic values of preoperative neutrophil-to-lymphocyteratio (NLR), platelet-to-lymphocyte ratio (PLR) andlymphocyte-to-monocyte ratio (LMR) for patients withmuscle-invasive bladder cancer (MIBC) undergoingradical cystectomy.METHODS: The clinical data of 186 MIBC patientsreceiving radical cystectomy from January 2013 toOctober 2015 were collected. Receiver operating characteristic (ROC) curves were plotted based on preoperative NLR, PLR and LMR as well as survival of patientswithin 5 years after surgery. The NLR, PLR and LMRvalues of patients with different clinicopathological characteristics were described by frequencies.Recurrence-free survival curve was plotted using theKaplan-Meier method, and survival curves were compared by the log-rank test. Independent risk factorsfor recurrence were explored by multivariate logistic regression analysis. NLR, PLR and LMR were utilizedto establish the recurrence risk scoring model, and theaccuracy for predicting recurrence was assessed byROC curves.RESULTS: NLR groups had significantly differentpathological grade, T stage, lymph node metastasis and tumor number. The differences in age,pathological grade, T stage, lymph node metastasisand tumor number were significant between PLRgroups. Gender, pathological grade, T stage, lymphnode metastasis, tumor number and tumor sizehad significant differences between LMR groups(P<0.05). There were significant differences in recurrence-free survival rate between NLR≥2.45 andNLR<2.45 groups (30.21% vs. 71.11%), PLR≥157.3and PLR<157.3 groups (26.73% vs. 77.65%), andLMR≥3.72 and LMR<3.72 groups (79.10% vs.33.61%) (P<0.001). Pathological grade, T stage,tumor number, lymph node metastasis, NLR, PLRand LMR were independent risk factors for MIBCpatients. After these factors were included into therecurrence risk scoring model, the area under ROCcurve was 0.821.CONCLUSIONS: Preoperative NLR, PLR and LMR are potential biomarkers

RESUMEN

OBJETIVOS: Estudiar el valor pronóstico del índice neutrófilo-linfocito (INL), plaqueta-linfocito (IPL) y linfocito-monocito (ILM) preoperatorioen pacientes con Cáncer de Vejiga Músculo Invasivo(CVMI) sometidos a cistectomía radical.MÉTODOS: Se analizaron los datos clínicos de 186pacientes con CVMI sometidos a cistectomía desdeEnero 2013 a Octubre 2015. Se ejecutaron curvasReceiver operating characteristics (ROC) basadas enel valor preoperatorio de INL, IPL, ILM así como la supervivencia a los 5 años de la cirugía. Los valores delos INR, IPL, ILM de los pacientes con diferentes características clínicopatológicas se describieron mediantefrecuencias. Se obtuvo una curva de supervivencia libre de recurrencia usando el método de Kaplan-Meier,mientras que las curvas de supervivencias se compararon con el log-rank test. Se exploraron los factoresindependientes de recurrencia a través de un análisisde regresión logística. Se usaron los INL, IPL, ILM paraestablecer un modelo predictive de riesgo de recurrencia cuya precision fue evaluada con curvas ROC.RESULTADOS: Las diferencias fueron significativaspara los grupos INL en cuanto a grado histológico,estadio tumoral, metastasis ganglionares y númerode tumores. Las diferencias en edad, grado histológico, estadio tumoral, metastasis a ganglios linfáticosy número de tumores fueron significativas entre losgrupos IPL. Mientras que en los grupos ILM las diferencias fueron significativas en género, grado histológico, estadio tumar, metastasis a ganglios linfáticos,número y tamaño tumoral. (P<0.05). Hubo diferenciassignificativas en la tasa de recurrencia libre de enfermedad en los grupos INL≥2.45 e INL<2.45 (30.21% vs.71.11%), los grupos IPL≥157.3 e IPL<157.3 (26.73% vs.77.65%), y los grupos ILM≥3.72 e ILM<3.72 (79.10%vs. 33.61%) (P<0.001). El grado histológico, estadio tumoral, número de tumores, metastasis ganglionares,INL, IPL, ILM fueron factores de riesgo independientesen pacientes con CVMI. Después