Role of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Prognostic Predictors Before Treatment for Metastatic Bladder Cancer Patients Receiving First-Line Chemotherapy

Abstract

Objective: The correlation between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and the prognosis of different cancers has been determined by a series of studies. The role of these inflammatory markers as definitive prognostic factors in bladder cancer is controversial. This research was conducted to explore the prognostic worth of pretreatment inflammatory markers including NLR and PLR in metastatic bladder cancer (mBC) patients receiving first-line chemotherapy. Materials and Methods: We retrospectively appraised 71 patients diagnosed with mBC from August 2005 to November 2017. According to the threshold values that were identified by receiver operating characteristic (ROC) curve analysis, the NLR and PLR were each divided into two groups: first, ≤2.93 and >2.93, and second, ≤168.9 and >168.9 respectively. The Cox proportional hazards model was applied to uncover the probable predictors of progression-free survival (PFS) and overall survival (OS). Results: Findings obtained by univariate analysis determined that an elevated NLR, a high PLR, and the onset of anemia were significantly correlated with poorer OS. Additionally, a significant relationship was found between an elevated NLR and reduced PFS. In the multiple analysis, an elevated NLR was identified as an independent predictor for both, reduced OS (Odds Ratio (OR): 5.58, 95% Confidence interval (CI): 2.80–11.13, p<0.05) and PFS (OR: 3.43, 95% CI: 1.92–6.12, p<0.05). Conclusion: Findings of this research revealed that NLR was an independent prognostic tool of PFS and OS in mBC patients undergoing first-line chemotherapy.

Keywords

• metastatic bladder cancer
• neutrophil-to-lymphocyte ratio
• platelet-to-lymphocyte ratio
• prognosis