Can Neutrophil-to-Lymphocyte ratio predict the response to BCG in high-risk non muscle invasive bladder cancer?
Int. braz. j. urol
; 45(2): 315-324, Mar.-Apr. 2019. tab, graf
Article
em En
| LILACS
| ID: biblio-1002193
Biblioteca responsável:
BR1.1
ABSTRACT
ABSTRACT Objectives:
To evaluate the neutrophil-to-lymphocyte ratio (NLR) as a prognostic factor for response of high risk non muscle invasive bladder cancer (HRNMIBC) treated with BCG therapy. Materials andMethods:
Between March 2010 and February 2014 in a tertiary center 100 consecutive patients with newly diagnosed HRNMIBC were retrospectively analyzed. Patients were divided according to NLR value 46 patients with NLR value less than 3 (NLR < 3 group), and 54 patients with NLR value more than 3 (NLR ≥ 3 group). At the end of follow-up 52 patients were high grade disease free (BCG-responder group) and 48 patients underwent radical cystectomy for high grade recurrence or progression to muscle invasive disease (BCG non-responder group). The average follow-up was 60 months. Intervention analysis and correlation of preoperative NLR value with response to BCG in terms of recurrence and progression.Results:
The optimal cut-off for NLR was ≥ 3 according to the receiver operating characteristics analysis (AUC 0.760, 95% CI, 0.669-0.850). Mean NLR value was 3.65 ± 1.16 in BCG non-responder group and 2.61 ± 0.77 in BCG responder group (p = 0.01). NLR correlated with recurrence (r = 0.55, p = 0.01) and progression risk scores (r = 0.49, p = 0.01). In multivariate analysis, NLR (p = 0.02) and EORTC recurrence risk groups (p = 0.01) were associated to the primary endpoint. The log-rank test showed statistically significant difference between NLR < 3 and NLR ≥ 3 curves (p < 0.05).Conclusions:
NLR value preoperatively evaluated could be a useful tool to predict BCG response of HRNMIBC. These results could lead to the development of prospective studies to assess the real prognostic value of NLR in HRNMIBC.Palavras-chave
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Base de dados:
LILACS
Assunto principal:
Neoplasias da Bexiga Urinária
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Vacina BCG
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Linfócitos
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Carcinoma de Células de Transição
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Adjuvantes Imunológicos
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Neutrófilos
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article