Clinical and pathological factors predictive of bladder cancer recurrence in patients with upper tract primary TCC.

OBJECTIVE: To evaluate predictive clinical and histopathological risk factors for bladder cancer recurrence in patients who underwent nephroureterectomy for primary upper urinary tract transitional cell carcinoma (TCC). SUBJECTS AND METHODS: Data of 111 patients, who were diagnosed with upper urinary tract TCC and underwent nephroureterectomy were reviewed A total of 65 patients were included in the study, after excluding 34 patients. Results: Bladder cancer recurrence developed in 20 (30.7%) of the 65 patients under evaluation. The recurrence-free survival rates in the 1st, 3rd, and 5th years were 78.4%, 70.7% and 69.2%, respectively. Lymphovascular invasion and a positive surgical margin were defined as risk factors for bladder cancer recurrence. In addition, patients with multiple tumors and low stage and grade pathology had a high rate of bladder cancer recurrence, although this was not statistically significant. CONCLUSION: After nephroureterectomy, a careful follow-up is required in terms of bladder tumor recurrence especially in patients with a positive surgical margin, lymphovascular invasion, low-grade tumors, or multifocal tumors.

Preoperative neutrophil-to-lymphocyte ratio (NLR) may be predictive of pathologic stage in patients with bladder cancer larger than 3 cm.

OBJECTIVE: Bladder cancer (BCa) is the most common malignancy of the urinary tract. In this study, we aimed to evaluate the ability of preoperative neutrophil-to-lymphocyte ratio (NLR) to predict pathologic stage of at the time of first transurethral resection of bladder tumor (TUR-BT) in patients with BCa larger than 3 cm. PATIENTS AND METHODS: Records of consecutive patients undergoing TUR-BT for BCa with a diameter >3 cm were reviewed. A total of 222 patients were eligible for analysis, and were divided into two groups: 162 patients in non-muscle-invasive BCa (NMIBC) group and 60 patients in muscle-invasive BCa (MIBC) group. Differences in preoperative blood parameters and NLR were evaluated between groups with an unequal variance t-test. RESULTS: In the NMIBC group, 59 patients had low-grade and 103 high-grade papillary urothelial carcinomas. 60 patients had T2 stage carcinoma. The mean age of the patients was 71.8 and 75.7 years, and mean NLR was 3.44 ± 2.03 and 4.6 ± 2.8 in NMIBC and MIBC groups, respectively. In terms of NLR, there was a statistically significant difference between the NMIBC and MIBC groups (p = 0.005). CONCLUSIONS: Our results showed that NLR might act as a significant predictive biomarker on the staging of BCa. Also, NLR could be used as a cost-effective, simple, common usable biomarker in urology clinic practice.