Systemic Inflammatory Response Based on Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker in Bladder Cancer

Table 3

Clinical studies on the prognostic value of SIR-related hematological biomarkers in upper urinary tract urothelial carcinoma.

Study	Marker	Publication year	Number of patients	Threshold	Assessment period	Main findings
Saito et al. [49]	CRP	2007	130	0.5 mg/dL	Before surgery	Patients with elevated (>0.5) CRP showed higher hemoglobin, advanced tumor stage (≥pT3), positive lymph node, high grade, and LVI; moreover, elevated (>0.5) CRP was significant prognostic factor for DSS and RFS
Obata et al. [52]	CRP	2013	183	0.5 mg/dL	Before surgery	Patients with elevated (>0.5) CRP showed advanced tumor stage (≥pT3), LVI, and higher number of metastases; moreover, elevated (>0.5) CRP was significant prognostic factor for worse RFS and CSS
Tanaka et al. [58]	CRP	2014	564	Multiple cut-offs (0.5, 2.0 mg/dL)	Before surgery	Elevated CRP (0.5–2.0 or >2.0) level was an independent predictor of worse RFS and CSS relative to normal CRP (≤0.5); in elevated pre-CRP (>0.5) group, postoperative normalization of CRP (≤0.5) was an independent predictor of better CSS
Ku et al. [55]	Albumin	2014	181	3.5 g/dL	Before surgery	Hypoalbuminemia (<3.5) was a significant predictor of worse DSS and OS; also, scoring model incorporated albumin discriminated patients well according to risk of DSS and OS
Hashimoto et al. [51]	Neutrophil count	2013	84	4000/uL	Before surgery	Elevated neutrophil count (≥4000/uL) was an independent prognostic factor for worse RFS
Azuma et al. [50]	NLR	2013	137	2.5	Before surgery	Elevated (≥2.5) NLR was significantly associated with worse RFS and CSS; also, scoring model incorporated NLR discriminated patients well according to risk of RFS and CSS
Dalpiaz et al. [53]	NLR	2014	202	2.7	Before surgery	Elevated (≥2.7) NLR was significantly associated with worse OS and CSS
Luo et al. [56]	NLR	2014	234	3	Before surgery	Elevated (≥3) NLR was significantly associated with worse MFS and CSS; also, the use of a NLR of >3 further identified a poor prognostic group, especially in patients with pT3 for MFS and CSS
Tanaka et al. [57]	NLR	2014	665	3	Before surgery	Patients with elevated (>3) NLR significantly showed high tumor grade (Gr 3), advanced tumor stage, positive lymph node, and LVI; elevated (≥3) NLR was an independent risk factor for worse RFS and CSS; furthermore, addition of pre-NLR slightly improved the accuracies of the base model for predicting both RFS and CSS
Sung et al. [60]	NLR	2015	410	2.5	Before surgery	Elevated NLR (≥2.5) was independent predictor of worse PFS, OS, and CSS, along with elevated ESR

CRP: C-reactive protein, NLR: neutrophil-to-lymphocyte ratio, LVI: lymphovascular invasion, OS: overall survival, DSS: disease-specific survival, RFS: recurrence-free survival, MFS: metastasis-free survival, and CSS: cancer specific survival.