The evaluation of associsation between serum Neutrophil-lymphocyte ratio and pathological prognostic factors, development of metastases during follow in stage I germ cell testicular tumor patients

Abstract

INTRODUCTION: The aim of this study is to assess the relationship between pathologic prognostic factors and metastasis development with serum neutrophil-lymphocyte ratio(NLO) before radical orchiectomy. METHODS: The data of 72 patients who underwent orchiectomy for clinical stage I testicular tumor between January 2009 and December 2016 were investigate retrospectively.Data were recorded for all patients including age, tumor laterality, tumor size, serum testis tumor(TT) markers, serum hemogram parameters, pathologic stage, prognostic factors detected in pathology specimens, and metastasis development.All comparisons were based on the median NLO cut-off value of 2.39. RESULTS: Mean age and mean tumor size in our patients were 38+-15 years and 35+-21 mm, respectively.Seminomas in 22 patients (30.5%), non-seminomic in 25 patients (34.7%), mixed germ cell TT in 25 patients (34.7%) were detected.The tunica vaginalis involvement in 4 patients (5.5%), rete testis involvement in 11 patients (15.2%), presence of lymphovascular invasion in 19 patients (26.4%) were detected.The proliferation rate of 21(%29.2) patients was more than 70%. In 22 patients (30.6%) the rate of embryonal carcinoma was found to be more than 50%.During the median follow-up period of 33 months(Min: 4-Max: 66 months), metastasis were detected in 14(19.4%) of the patients.In 22 patients with seminomatous tumor, there was a statistically significant difference in NLO between 7 patients whose tumor diameter was greater than 4 cm and 15 patients whose tumor size was less than 4 cm(3.46+-3.69 vs. 2.17+-0.9, p=0.038). DISCUSSION AND CONCLUSION: We determined serum NLO could only be used in patients with seminomatous TT whose tumor is larger than 4 cm in diameter.

Keywords

• metastasis
• neutrophil-lymphocyte ratio
• prognostic risk factors
• testis tumor