NLR is predictive of upstaging at the time of radical cystectomy for patients with urothelial carcinoma of the bladder

Aaron Potretzke, Luke Hillman, Kelvin Wong, Fangfang Shi, Ryan Brower, Stephanie Mai, Jeremy Cetnar, Edwin Jason Abel, Tracy M. Downs

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective: To evaluate the ability of preoperative neutrophil-lymphocyte ratio (NLR) to predict pathologic upstaging and nonorgan-confined (NOC) (≥pT3) disease. Methods and materials: After institutional review board approval, the records of consecutive patients undergoing radical cystectomy (RC) for urothelial carcinoma from 2002 to 2012 at the University of Wisconsin Hospital were reviewed. A total of 102 patients with NLR within 100 days of surgery were eligible for analysis. The primary outcome was difference in stage from preoperative assessment to time of RC. Differences in preoperative NLR between groups were evaluated with an unequal variance t test. A univariate analysis assessed whether NLR, preoperative stage, grade, associated lymphovascular invasion, preoperative hydronephrosis, gender, previous pelvic radiotherapy, previous intravesical bladder cancer treatments, or nodal stage were related to upstaging. Multivariate analyses were performed to evaluate the relationship of NLR to upstaging and relative organ-confined (≤pT2) and NOC disease. Results: Of 390 consecutive patients undergoing RC, 102 patients met study criteria. Overall, 55 (53.9%) patients were upstaged, 25 (25.5%) were unchanged, and 21 (20.6%) were downstaged. Fifty-one patients (50%) were upstaged to more advanced disease (≥pT3). NLR and preoperative hydronephrosis were significantly related to pathologic tumor staging. NLR, preoperative hydronephrosis, and preoperative tumor stage were significantly related to upstaging to NOC disease. Patients who were upstaged to≥pT3 demonstrated statistically significant greater NLRs (4.33±0.87) compared with patients who remained at≤pT2 stage (2.66±0.29) (P

Original languageEnglish (US)
Pages (from-to)631-636
Number of pages6
JournalUrologic Oncology: Seminars and Original Investigations
Volume32
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

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Cystectomy
Urinary Bladder
Neutrophils
Lymphocytes
Carcinoma
Hydronephrosis
Neoplasm Staging
Research Ethics Committees
Ambulatory Surgical Procedures
Urinary Bladder Neoplasms
Radiotherapy
Multivariate Analysis

Keywords

  • Bladder cancer
  • Lymphocyte
  • Neoadjuvant chemotherapy
  • Neutrophil
  • Upstaging

ASJC Scopus subject areas

  • Oncology
  • Urology
  • Medicine(all)

Cite this

NLR is predictive of upstaging at the time of radical cystectomy for patients with urothelial carcinoma of the bladder. / Potretzke, Aaron; Hillman, Luke; Wong, Kelvin; Shi, Fangfang; Brower, Ryan; Mai, Stephanie; Cetnar, Jeremy; Abel, Edwin Jason; Downs, Tracy M.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 32, No. 5, 2014, p. 631-636.

Research output: Contribution to journalArticle

Potretzke, Aaron ; Hillman, Luke ; Wong, Kelvin ; Shi, Fangfang ; Brower, Ryan ; Mai, Stephanie ; Cetnar, Jeremy ; Abel, Edwin Jason ; Downs, Tracy M. / NLR is predictive of upstaging at the time of radical cystectomy for patients with urothelial carcinoma of the bladder. In: Urologic Oncology: Seminars and Original Investigations. 2014 ; Vol. 32, No. 5. pp. 631-636.
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abstract = "Objective: To evaluate the ability of preoperative neutrophil-lymphocyte ratio (NLR) to predict pathologic upstaging and nonorgan-confined (NOC) (≥pT3) disease. Methods and materials: After institutional review board approval, the records of consecutive patients undergoing radical cystectomy (RC) for urothelial carcinoma from 2002 to 2012 at the University of Wisconsin Hospital were reviewed. A total of 102 patients with NLR within 100 days of surgery were eligible for analysis. The primary outcome was difference in stage from preoperative assessment to time of RC. Differences in preoperative NLR between groups were evaluated with an unequal variance t test. A univariate analysis assessed whether NLR, preoperative stage, grade, associated lymphovascular invasion, preoperative hydronephrosis, gender, previous pelvic radiotherapy, previous intravesical bladder cancer treatments, or nodal stage were related to upstaging. Multivariate analyses were performed to evaluate the relationship of NLR to upstaging and relative organ-confined (≤pT2) and NOC disease. Results: Of 390 consecutive patients undergoing RC, 102 patients met study criteria. Overall, 55 (53.9{\%}) patients were upstaged, 25 (25.5{\%}) were unchanged, and 21 (20.6{\%}) were downstaged. Fifty-one patients (50{\%}) were upstaged to more advanced disease (≥pT3). NLR and preoperative hydronephrosis were significantly related to pathologic tumor staging. NLR, preoperative hydronephrosis, and preoperative tumor stage were significantly related to upstaging to NOC disease. Patients who were upstaged to≥pT3 demonstrated statistically significant greater NLRs (4.33±0.87) compared with patients who remained at≤pT2 stage (2.66±0.29) (P",
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T1 - NLR is predictive of upstaging at the time of radical cystectomy for patients with urothelial carcinoma of the bladder

AU - Potretzke, Aaron

AU - Hillman, Luke

AU - Wong, Kelvin

AU - Shi, Fangfang

AU - Brower, Ryan

AU - Mai, Stephanie

AU - Cetnar, Jeremy

AU - Abel, Edwin Jason

AU - Downs, Tracy M.

PY - 2014

Y1 - 2014

N2 - Objective: To evaluate the ability of preoperative neutrophil-lymphocyte ratio (NLR) to predict pathologic upstaging and nonorgan-confined (NOC) (≥pT3) disease. Methods and materials: After institutional review board approval, the records of consecutive patients undergoing radical cystectomy (RC) for urothelial carcinoma from 2002 to 2012 at the University of Wisconsin Hospital were reviewed. A total of 102 patients with NLR within 100 days of surgery were eligible for analysis. The primary outcome was difference in stage from preoperative assessment to time of RC. Differences in preoperative NLR between groups were evaluated with an unequal variance t test. A univariate analysis assessed whether NLR, preoperative stage, grade, associated lymphovascular invasion, preoperative hydronephrosis, gender, previous pelvic radiotherapy, previous intravesical bladder cancer treatments, or nodal stage were related to upstaging. Multivariate analyses were performed to evaluate the relationship of NLR to upstaging and relative organ-confined (≤pT2) and NOC disease. Results: Of 390 consecutive patients undergoing RC, 102 patients met study criteria. Overall, 55 (53.9%) patients were upstaged, 25 (25.5%) were unchanged, and 21 (20.6%) were downstaged. Fifty-one patients (50%) were upstaged to more advanced disease (≥pT3). NLR and preoperative hydronephrosis were significantly related to pathologic tumor staging. NLR, preoperative hydronephrosis, and preoperative tumor stage were significantly related to upstaging to NOC disease. Patients who were upstaged to≥pT3 demonstrated statistically significant greater NLRs (4.33±0.87) compared with patients who remained at≤pT2 stage (2.66±0.29) (P

AB - Objective: To evaluate the ability of preoperative neutrophil-lymphocyte ratio (NLR) to predict pathologic upstaging and nonorgan-confined (NOC) (≥pT3) disease. Methods and materials: After institutional review board approval, the records of consecutive patients undergoing radical cystectomy (RC) for urothelial carcinoma from 2002 to 2012 at the University of Wisconsin Hospital were reviewed. A total of 102 patients with NLR within 100 days of surgery were eligible for analysis. The primary outcome was difference in stage from preoperative assessment to time of RC. Differences in preoperative NLR between groups were evaluated with an unequal variance t test. A univariate analysis assessed whether NLR, preoperative stage, grade, associated lymphovascular invasion, preoperative hydronephrosis, gender, previous pelvic radiotherapy, previous intravesical bladder cancer treatments, or nodal stage were related to upstaging. Multivariate analyses were performed to evaluate the relationship of NLR to upstaging and relative organ-confined (≤pT2) and NOC disease. Results: Of 390 consecutive patients undergoing RC, 102 patients met study criteria. Overall, 55 (53.9%) patients were upstaged, 25 (25.5%) were unchanged, and 21 (20.6%) were downstaged. Fifty-one patients (50%) were upstaged to more advanced disease (≥pT3). NLR and preoperative hydronephrosis were significantly related to pathologic tumor staging. NLR, preoperative hydronephrosis, and preoperative tumor stage were significantly related to upstaging to NOC disease. Patients who were upstaged to≥pT3 demonstrated statistically significant greater NLRs (4.33±0.87) compared with patients who remained at≤pT2 stage (2.66±0.29) (P

KW - Bladder cancer

KW - Lymphocyte

KW - Neoadjuvant chemotherapy

KW - Neutrophil

KW - Upstaging

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