Usefulness of the Neutrophil/Lymphocyte Ratio as Predictor of Recurrence and Progression of Non-Muscle-Invasive Bladder Carcinoma

  • Nuno Ramos Serviço de Urologia, Hospital Garcia de Orta, EPE, Almada, Portugal
  • Celso Marialva Serviço de Urologia, Hospital Garcia de Orta, EPE, Almada, Portugal
  • Vanessa Metrogos Serviço de Urologia, Hospital Garcia de Orta, EPE, Almada, Portugal
  • João Paulo Rosa Serviço de Urologia, Hospital Garcia de Orta, EPE, Almada, Portugal
  • Nelson Menezes Serviço de Urologia, Hospital Garcia de Orta, EPE, Almada, Portugal
Keywords: Biomarkers, Lymphocytes, Neoplasm Recurrence, Local, Neutrophils, Prognosis, Risk Factors, Urinary Bladder Neoplasms


Objectives: Assess whether the neutrophil-lymphocyte ratio (RNL) can predict the risk of recurrence and progression of patients with the non–muscle-invasive bladder carcinoma (CBNMI).

Material & Methods: It was performed a retrospective analysis of patients diagnosed with CBNMI after a resection of the bladder tumor (RTUV), between January 2013 and December 2014. Patients who had no white blood cell count prior to surgery and patients with synchronous tumors were excluded. It was subsequently performed a multivariate statistical analysis with SPSS 22.0® software, with the following variables: age, gender, time of recurrence or disease progression (in months), NLR, tumor size (≤ 3 or >3cm), multiple tumors, histology and tumor initial grade.

Results: The sample consists of 84 patients, 79.8% were males and the average age was 69 years.

In 67.9% of the patients the initial tumor histology was pTa and in 77.4% was a low-grade tumor. In 21.4% of patients the tumor was multiple and in 33.3% the tumor was larger than 3 cm.

Nineteen-percent of patients had recurrence of tumor and progression was verifyed in 16.4%. Patients with RNL>3.32 presented pT1 as initial tumor histology more often (p=0.018).
In a multivariate analysis, the RNL> 3.32 was found to be associated with a higher recurrence or progression of tumor (hazard ratio [HR] = 2.94; 95% CI: 1.27-6.8; p=0012.).

Conclusions: In conclusion, this study states that RNL may be an useful predictor of recurrence or progression of tumor in patients with CBNMI, valuable in the clinical decision.


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