Aim: To investigate the prognostic role of neutrophil percentage-to-albumin ratio (NPAR) in muscle-invasive bladder cancer (MIBC) patients treated with neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Patients & methods: 213 patients were included. Inclusion criteria: Nonmetastatic, MIBC (cT2-T4aN0M0), at least three cycles of NAC, undergone RC and with blood count within 30 days before NAC. Results: Five-years overall survival (OS) with NPAR >18 was 34.06% (95% CI: 18.3-50.5) and 65.37% (95% CI: 52.4-75.6) with NPAR <18. Five years cancer-specific survival (CSS) with NPAR >18 was 42.9% (95% CI: 23.9-60.7) and 74.5% (95% CI: 62.6-83.1) with NPAR <18 (p < 0.001). In multivariable analysis, NPAR increased OS of 1.3 points and CSS of 4.37 points. Conclusion: High NPAR prior to NAC seems to be a strong predictor of OS and CSS in MIBC patients treated with NAC and RC.Lay abstract: This research demonstrated that presence of a high neutrophil percentage-to-albumin ratio in patients with muscle-invasive bladder cancer prior neoadjuvant chemotherapy and radical cystectomy is associated with worse outcomes and reduced overall and cancer-specific survival. Thus, neutrophil percentage-to-albumin ratio could be a useful biological marker in clinical practice to help predict outcomes for patients with muscle-invasive bladder cancer.

Neutrophil percentage-to-albumin ratio predicts mortality in bladder cancer patients treated with neoadjuvant chemotherapy followed by radical cystectomy

Soria, Francesco;Gontero, Paolo;Scarpa, Roberto Mario;Manfredi, Matteo;Porpiglia, Francesco;
2021-01-01

Abstract

Aim: To investigate the prognostic role of neutrophil percentage-to-albumin ratio (NPAR) in muscle-invasive bladder cancer (MIBC) patients treated with neoadjuvant chemotherapy (NAC) and radical cystectomy (RC). Patients & methods: 213 patients were included. Inclusion criteria: Nonmetastatic, MIBC (cT2-T4aN0M0), at least three cycles of NAC, undergone RC and with blood count within 30 days before NAC. Results: Five-years overall survival (OS) with NPAR >18 was 34.06% (95% CI: 18.3-50.5) and 65.37% (95% CI: 52.4-75.6) with NPAR <18. Five years cancer-specific survival (CSS) with NPAR >18 was 42.9% (95% CI: 23.9-60.7) and 74.5% (95% CI: 62.6-83.1) with NPAR <18 (p < 0.001). In multivariable analysis, NPAR increased OS of 1.3 points and CSS of 4.37 points. Conclusion: High NPAR prior to NAC seems to be a strong predictor of OS and CSS in MIBC patients treated with NAC and RC.Lay abstract: This research demonstrated that presence of a high neutrophil percentage-to-albumin ratio in patients with muscle-invasive bladder cancer prior neoadjuvant chemotherapy and radical cystectomy is associated with worse outcomes and reduced overall and cancer-specific survival. Thus, neutrophil percentage-to-albumin ratio could be a useful biological marker in clinical practice to help predict outcomes for patients with muscle-invasive bladder cancer.
2021
7
7
1
10
bladder cancer; neoadjuvant chemotherapy; neutrophil percentage-to-albumin ratio; neutrophil-to-lymphocyte ratio; survival
Ferro, Matteo; Babă, Dragoş-Florin; de Cobelli, Ottavio; Musi, Gennaro; Lucarelli, Giuseppe; Terracciano, Daniela; Porreca, Angelo; Busetto, Gian Maria; Del Giudice, Francesco; Soria, Francesco; Gontero, Paolo; Cantiello, Francesco; Damiano, Rocco; Rocco, Papalia; Scarpa, Roberto Mario; Abu Farhan, Abdal Rahman; Autorino, Riccardo; Brescia, Antonio; Marchioni, Michele; Mari, Andrea; Minervini, Andrea; Longo, Nicola; Chiancone, Francesco; Perdona', Sisto; Barone, Biagio; Placido, Pietro De; Catellani, Michele; Bottero, Danilo; Ditonno, Pasquale; Battaglia, Michele; Zamboni, Stefania; Antonelli, Alessandro; Greco, Francesco; Russo, Giorgio Ivan; Smelzo, Salvatore; Hurle, Rodolfo; Crisan, Nicolae; Manfredi, Matteo; Porpiglia, Francesco; Crocetto, Felice; Buonerba, Carlo; Danilesco, Alina; Vartolomei, Mihai Dorin
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1796547
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