comparison of preoperative neutrophil–lymphocyte, lymphocyte–monocyte, and platelet–lymphocyte ratios in patients with upper urinary tract urothelial carcinoma undergoing radical nephroureterectomy

Xin Song,* Gui-Ming Zhang,* Xiao-Cheng Ma, Lei Luo, Bin Li, Dong-Yue Chai, Li-Jiang Sun Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China *These authors contributed equally to this work Purpose: The aim of this study was to investigate the prognostic value of preoperative neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and lymphocyte–monocyte ratio (LMR) in patients with upper urinary tract urothelial carcinoma (UUTUC).Methods: We retrospectively analyzed the clinical data of 140 patients with UUTUC who underwent radical nephroureterectomy from January 2005 to December 2011. We plotted receiver operating characteristic curves of NLR, PLR, and LMR for the diagnosis of tumor recurrence. Survival analysis was performed using the Kaplan–Meier method and log-rank test. Independent risk factor analysis was performed using a Cox proportional hazards regression model.Results: Receiver operating characteristic curves showed that NLR was superior to PLR and LMR as a predictive factor in patients with UUTUC undergoing radical nephroureterectomy. Univariate analysis revealed that NLR (P<0.001 and P<0.001), PLR (P=0.01 and P<0.001), and LMR (P<0.001 and P<0.001) were significantly associated with disease-free survival and progression-free survival (PFS), respectively. Multivariate analysis identified NLR and LMR as independent prognostic factors for disease-free survival (P=0.035 and P=0.002) and PFS (P=0.005 and P=0.002), respectively.Conclusion: NLR and LMR could be independent predictors of disease-free survival and PFS, and NLR is a superior predictive factor to LMR. Keywords: prognostic factors, neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, lymphocyte–monocyte ratio