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Prognostic Marker for Non–Muscle-Invasive Bladder Cancer

By: Lauren Harrison, MS
Posted: Monday, January 14, 2019

The neutrophil-to-lymphocyte ratio plays a strong prognostic and decision-making role in the treatment of primary T1 HG/G3 non–muscle-invasive bladder cancer, according to a study by Mihai Dorin Vartolomei, MD, PhD, of the European Institute of Oncology in Milan, and his colleagues. Published in Clinical Genitourinary Cancer, these study findings confirm that a pretreatment neutrophil-to-lymphocyte ratio of at least 3 can predict worse outcomes for progression-free, recurrence-free, and cancer-specific survival for patients with this type of genitourinary cancer.

From 2002 to 2012, the neutrophil-to-lymphocyte ratio was assessed in 1,046 patients before transurethral bladder resection. The 512 patients (48.9%) who had a neutrophil-to-lymphocyte ratio of at least 3 had a 5-year recurrence-free survival of 9.4%, compared with 58.8% for patients with a ratio of less than 3. The 5-year progression-free survival was 57.1% and 79.2% for patients with a ratio of 3 or greater and less than 3, respectively. The 10-year cancer-specific survival for the two groups was 77.4% and 84.3%, with no significant difference in overall survival.

The authors noted that adding this marker to a multivariate model of oncologic outcomes may improve the precision of those models. Inclusion of neutrophil-to-lymphocyte ratio improved the prediction of recurrence-free survival by 6.9%, progression-free survival by 1.8%, and cancer-specific survival by 1.7%.

“Taken together, these findings support the prognostic role of inflammation in [non–muscle-invasive bladder cancer] and its therapeutic implications,” the authors concluded.

Disclosure: The study authors reported no conflicts of interest.

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