Perioperative change in neutrophil-lymphocyte ratio predicts the overall survival of patients with bladder cancer undergoing radical cystectomy

Objective

To assess the prognostic value of perioperative changes in the neutrophil–lymphocyte ratio in patients with bladder cancer undergoing radical cystectomy.

Methods

We performed a retrospective analysis of 323 patients who had undergone radical cystectomy at our institutions. Overall survival was assessed with the Kaplan–Meier method and Cox regression analysis.

Results

Preoperative and postoperative neutrophil–lymphocyte ratios were significantly correlated with overall survival (both P = 0.0001). Changes in perioperative neutrophil–lymphocyte ratio stratified the patients into two groups, designated favorable- and poor-risk groups, with significantly different 5-year overall survival rates (75.1% and 41.4%, respectively; P < 0.0001). Multivariate Cox regression analyses showed that the perioperative change in neutrophil–lymphocyte ratio was an independent prognostic factor for overall survival (hazard ratio 2.56, 95% confidence interval 1.75–3.73; P < 0.001). Moreover, a decrease in neutrophil–lymphocyte ratio after adjuvant chemotherapy was associated with favorable overall survival in patients with high postoperative neutrophil–lymphocyte ratio (P < 0.001), indicating that neutrophil–lymphocyte ratio may be a predictive factor for the efficacy of adjuvant chemotherapy.

Conclusions

Perioperative changes in neutrophil–lymphocyte ratio are significantly associated with overall survival in patients with bladder cancer undergoing radical cystectomy. Follow-up of the neutrophil–lymphocyte ratio change may be useful for the clinical management of patients after surgery.

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