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Minerva Urologica e Nefrologica 2018 June;70(3):300-9

DOI: 10.23736/S0393-2249.18.02914-4


language: English

Prognostic value of preoperative systemic inflammation markers in localized upper tract urothelial cell carcinoma: a large, multicenter cohort analysis

Sumin SON 1, Eu-Chang HWANG 1 , Seung-Il JUNG 1, Dong-Deuk KWON 1, Seock-Hwan CHOI 2, Tae-Gyun KWON 2, Joon-Hwa NOH 3, Myung-Ki KIM 4, Ill-Young SEO 5, Chul-Sung KIM 6, Sung-Gu KANG 7, Jun CHEON 7, Hong-Koo HA 8, Chang-Wook JEONG 9, Ja-Hyeon KU 9, Cheol KWAK 9, Hyeon-Hoe KIM 9

1 Department of Urology, Chonnam National University Medical School, Gwangju, South Korea; 2 Department of Urology, Kyungpook National University School of Medicine, Daegu, South Korea; 3 Department of Urology, Kwangju Christian Hospital, Gwangju, South Korea; 4 Department of Urology, Chonbuk National University Medical School, Jeonju, South Korea; 5 Department of Urology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea; 6 Department of Urology, Chosun University School of Medicine, Gwangju, South Korea; 7 Department of Urology, Korea University College of Medicine, Seoul, South Korea; 8 Department of Urology, Pusan National University School of Medicine, Busan, South Korea; 9 Department of Urology, Seoul National University College of Medicine, Seoul, South Korea


BACKGROUND: The aim of this study was to investigate the prognostic value of preoperative systemic inflammation markers in upper tract urothelial carcinoma (UTUC).
METHODS: A total of 1137 patients who underwent radical nephroureterectomy with bladder cuff excision at 9 institutions from 2004 to 2015, were retrospectively reviewed. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for each patient were calculated. Univariable and multivariable analysis was performed using the Cox proportional hazards regression model. Cut-off values for NLR and PLR were calculated using a receiver operating characteristic curve.
RESULTS: The median follow-up period was 39.1 (interquartile range: 18.3-63.8) months. Univariable analysis revealed that GPS, mGPS, PLR, and NLR (all, P=0.001) were significantly associated with both recurrence-free survival (RFS) and cancer-specific survival (CSS). Multivariable analysis revealed that GPS (P=0.001), PLR (hazards ratio [HR] =1.32; 95% CI: 1.08-1.62, P=0.007 and HR =1.87; 95% CI: 1.21-2.92, P=0.005), NLR (HR =1.38; 95% CI: 1.12-1.69, P=0.003 and HR =1.70; 95% CI: 1.10-2.62, P=0.017) were significantly associated with RFS and CSS.
CONCLUSIONS: Our results suggest that preoperative systemic inflammation markers such as GPS, PLR, and NLR are independent prognostic factors in patients with UTUC after surgery.

KEY WORDS: Inflammation - Prognosis - Carcinoma, transitional cell

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