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Neutrophil lymphocyte ratio predicts progression of non muscle invasive bladder cancer – prospective study one year follow up

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Sources of Funding: none

Introduction

Non muscle invasive bladder cancer is a recurrent and progressive disease; currently we are unable to forecast recurrence in the individual patient. Recently we developed a mathematical model that found NLR as a good prognostic tool. The model was tested retrospectively in an additional study and found accurate too. The aim of the current study is to assess its accuracy to forecast recurrence prospectively in patients with NMIBC

Methods

All patients admitted to bladder tumor resection (TURBT) and agreed to participate in the study had blood drawn for blood count 24 hours prior to surgery. Patients with non-muscle invasive tumor were recruited and prospectively followed. Patients had urine cytology and cystoscopy every 3 months for 2 years following resection. Time to recurrence and recurrence free of tumor were recorded. Statistical analysis was done with X2 test for categorical parameters and T test for serial parameters. Logistic regression was performed to forecast prognosis.

Results

123 patients were recruited, mean age was 71 years, all patients had at least 1 year follow up. Twenty nine patients (23.6%) experienced biopsy proven tumor recurrence. The mean time for recurrence was 7.38 months._x000D_ Neutrophil to Lymphocyte rate > 2 showed direct statistically significant correlation with tumor recurrence (p=0.038), tumor stage showed the same correlation (p=0.048). The specificity of our recurrence forecasting model was 96.8%. EORTC score did not demonstrate significance between the recurrent and non-recurrent groups._x000D_

Conclusions

Our mathematical model that found NLR as a prognostic tool in patients with NMIBC was tested for the first time prospectively. The model demonstrated its ability to forecast recurrence more accurately then tumor stage grade and EORT score in the individual patient with NMIBC._x000D_ The main limitation of this work is the relatively low number of patients._x000D_ _x000D_

Funding

none

Authors
Itamar Getzler
Zaher Bahouth
Ofer Nativ
Jacob Rubinstein
Sarel Halachmi
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