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J Cancer 2023; 14(7):1174-1181. doi:10.7150/jca.76977 This issue Cite

Research Paper

Prognostic impact of postoperative neutrophil-to-lymphocyte ratio on survival outcomes of patients treated with radical nephroureterectomy for upper urinary tract urothelial carcinoma: a single institution retrospective analysis using propensity score matching

Hyung Suk Kim1, Hui Seung Lee2, Ja Hyeon Ku3✉

1. Department of Urology, Dongguk University Ilsan Medical Center, Dongguk University College of Medicine, Goyang-si, Gyeonggi-do, Korea
2. Department of Biostatistics, Dongguk University College of Medicine, Goyang-si, Republic of Korea
3. Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

✉ Corresponding author: Ja Hyeon Ku, M.D. PhD., Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; Tel: 82-2-2072-0361; Fax: 82-2-742- More

Citation:
Kim HS, Lee HS, Ku JH. Prognostic impact of postoperative neutrophil-to-lymphocyte ratio on survival outcomes of patients treated with radical nephroureterectomy for upper urinary tract urothelial carcinoma: a single institution retrospective analysis using propensity score matching. J Cancer 2023; 14(7):1174-1181. doi:10.7150/jca.76977. https://www.jcancer.org/v14p1174.htm
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Abstract

Graphic abstract

Purpose: To investigate the prognostic impact of postoperative neutrophil to lymphocyte ratio (NLR) on survival outcomes in upper urinary tract urothelial carcinoma (UTUC).

Materials and methods: Data from 397 patients with UTUC who underwent radical nephroureterectomy (RNU) without a history of neoadjuvant chemotherapy between 2002 and 2017 were retrospectively analyzed. Based on a postoperative NLR cut-off of 3, patients were divided into low NLR (<3) or high NLR (≥ 3) groups. After 2:1 propensity score matching, a Kaplan-Meier with log-rank test was used to compare survival outcomes between the two groups. Univariate and multivariate Cox proportional hazard models were used to investigate the impact of the postoperative NLR on survival outcomes.

Results: The matched cohort (n=176) consisted of 116 low NLR and 60 high NLR patients. The Kaplan-Meier curves showed significant differences in the 3- and 5-year overall and cancer-specific survival rates between the two groups (each p = 0.03). Multivariate Cox regression analysis revealed that a postoperative high NLR was an independent predictor of worse overall survival (hazard ratio [HR]:2.13; 95% confidence interval [CI]:1.18-3.85, p = 0.012) and cancer-specific survival (HR:2.16; 95% CI 1.11-4.21, p = 0.024).

Conclusions: Propensity score matching analysis revealed postoperative high NLR can be considered a potential inflammatory biomarker for predicting survival outcomes of UTUC patients treated with RNU.

Keywords: Carcinoma, transitional cell, nephroureterectomy, neutrophil to lymphocyte ratio, systemic inflammatory response, survival

Citation styles

APA
Kim, H.S., Lee, H.S., Ku, J.H. (2023). Prognostic impact of postoperative neutrophil-to-lymphocyte ratio on survival outcomes of patients treated with radical nephroureterectomy for upper urinary tract urothelial carcinoma: a single institution retrospective analysis using propensity score matching. Journal of Cancer, 14(7), 1174-1181. https://doi.org/10.7150/jca.76977.

ACS
Kim, H.S.; Lee, H.S.; Ku, J.H. Prognostic impact of postoperative neutrophil-to-lymphocyte ratio on survival outcomes of patients treated with radical nephroureterectomy for upper urinary tract urothelial carcinoma: a single institution retrospective analysis using propensity score matching. J. Cancer 2023, 14 (7), 1174-1181. DOI: 10.7150/jca.76977.

NLM
Kim HS, Lee HS, Ku JH. Prognostic impact of postoperative neutrophil-to-lymphocyte ratio on survival outcomes of patients treated with radical nephroureterectomy for upper urinary tract urothelial carcinoma: a single institution retrospective analysis using propensity score matching. J Cancer 2023; 14(7):1174-1181. doi:10.7150/jca.76977. https://www.jcancer.org/v14p1174.htm

CSE
Kim HS, Lee HS, Ku JH. 2023. Prognostic impact of postoperative neutrophil-to-lymphocyte ratio on survival outcomes of patients treated with radical nephroureterectomy for upper urinary tract urothelial carcinoma: a single institution retrospective analysis using propensity score matching. J Cancer. 14(7):1174-1181.

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