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Sobolev, N.
Pre-treatment lymphocyte-monocyte ratio (LMR) as a potential prognostic factor in a cohort of patients with upper tract urothelial carcinoma
Studium für die Gleichwertigkeit; Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2014. pp. 6969 [OPEN ACCESS]
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Authors Med Uni Graz:
Advisor:: Hutterer Georg
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Abstract:: Objectives: To investigate the potential prognostic impact of the lymphocytemonocyte ratio (LMR) in a large European cohort of localized upper urinary tract urothelial carcinoma (UTUC) patients. The LMR as an indicator of systemic inflammatory response has been shown to represent a potential prognostic factor in various types of human cancers. Up to date, the prognostic significance of the LMR in UTUC has not been evaluated yet. Materials and methods: Clinico-pathological data from 182 non-metastatic UTUC patients, operated between 1990 and 2012 at a single tertiary academic center, were evaluated retrospectively. Pre-treatment LMR was assessed one day before surgery. Patients were categorized using a LMR cut-off value of 2.0 according to a calculation by receiver-operating curve analysis. Patients’ overall survival (OS) was assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of the LMR, a multivariate proportional Cox regression model was applied for OS. Results: In multivariate analyses, age at the date of surgery (<65 vs. >65yrs., HR=2.10, 95%CI=1.22-3.64, p=0.008), pathologic T-stage (pT1 vs. pT2-4, HR=2.15, 95%CI=1.26-3.67, p=0.005), as well as the LMR (<2 vs. >2, HR=0.56, 95%CI=0.35- 0.92, p=0.021) were independent predictors of UTUC patients’ OS. Conclusions: In the cohort studied, patients with an elevated (>2) pre-operative LMR had a subsequently longer OS after radical surgery for UTUC, compared to those with a low (<2) pre-operative LMR. Thus, we believe this parameter might be considered an additional prognostic factor in UTUC in the future.