Prognostic Analysis of Neutrophil/Lymphocyte Ratio and Thrombocyte/Lymphocyte Value Before Trimodal Treatment in Invasive Bladder Cancer

Introduction: To evaluate whether neutrophil/lymphocyte (NLR) and platelet/lymphocyte (PLR) ratios have prognostic value in patients undergoing bladder conserving treatment (trimodal therapy). Methods: A total of 40 patients receiving trimodality treatment for invasive bladder cancer were included in the study retrospectively. NLR and PLR were obtained for every patient before trimodality treatment was applied. We investigated whether NLR and PLR values had prognostic value for survival. Results: Gender, age, T stage, Histologic grade, radiotherapy dose, NLR and PLR values were evaluated in bladder cancer patients receiving trimodal therapy. In the receiver operating characteristic analysis, the optimum cut-off value for NLR was found to be 3.2 (sensitivity 71.4%, specificity 65.2% p<0.025). Area under the curve (AUC): 0.717, confidence interval (CI) 95% (0.557-0.877), the optimum cut-off for PLR was found as 152.25 (sensitivity 78.1%, specificity 64.2%, p<0.006), AUC: 0.764, CI 95% (0.610-0.917). Survival analysis showed that disease-free survival was 52.36 +/- 6 months and statistically significant in patients with an NLR value greater than 3.2 (p=0.023). PLR value above 152.25 was found to be an independent risk factor for disease-free survival (52.8 +/- 6.1 months) and overall survival (50.6 +/- 7.2 months) (p=0.043, p=0.011, respectively). Conlusion: NLR and PLR before trimodal treatment in invasive bladder cancer patients may be considered as a prognostic factor for disease progression. NLR and PLR values should be taken into consideration when deciding on trimodal treatment.