Introduction

Systemic inflammatory prognostic markers have been identified for several types of cancer. However, it remains unclear which markers are best for determining prognosis. The aim of this study was to investigate the prognostic value of preoperative systemic inflammatory markers in upper tract urothelial carcinoma (UTUC).

Methods

A total of 1,137 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. Multivariable analysis was performed using a Cox proportional hazards regression model. Cut-off values for NLR and PLR were calculated using a receiver operating characteristic curve (ROC).

Results

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 recurrence-free survival (RFS) and cancer-specific survival, (CSS). Multivariable analysis revealed that GPS (p = 0.001), PLR (hazard ratio [HR] = 1.34; 95% confidence interval [CI]: 1.10-1.63, p = 0.003 and HR = 1.81; 95% CI: 1.17-2.78, p = 0.002), and NLR (HR = 1.39; 95% CI: 1.14-1.72, p = 0.001 and HR = 1.70; 95% CI: 1.13-2.58, p = 0.011) were significantly associated with RFS and CSS.

Conclusions

Our results suggest that preoperative systemic inflammatory markers such as GPS, PLR, and NLR are independent prognostic factors in patients with UTUC after surgery

Funding

none