The prognostic role of neutrophil to lymphocyte (NLR) and platelet count has been proposed in various type of cancer. However, limited result exists in the field of metastatic urothelial carcinoma (UC). We assess the prognostic value of NLR and platelet count in chemotherapy-treated UC.
We retrospectively analyzed 256 patients with metastatic UC who underwent systemic chemotherapy between January 1997 and December 2014 in Kaohsiung Chang Gung Memorial Hospital. The cut-off values of NLR and platelet count were 3.0 and 400 x 109/L, respectively. We combined NLR and platelet count as a new prognostic score (NPS). The overall survival (OS) was calculated using Kaplan-Meier analyses. Multivariable analysis was performed by Cox proportional regression models.
The median follow-up period was 61.1 months. On univariate analysis, patients with a NLR ≥ 3.0 had a significant shorter survival than those with NLR < 3.0 (12.5 vs. 19.0 months, p = 0.001), as well as a worse survival outcome in patients with platelet count ≥ 400 x 109/L (11.0 vs. 15.0 months, p < 0.0001). The median OS in patients with NPS 0, 1, and 2 were 19.0, 12.8 and 9.3 months, respectively (p < .0001). Multivariate analysis revealed that NPS (hazard ratio [HR] 1.64, 95% confidence interval [CI] 1.20-2.24, p = 0.002), histologic variant (HR 1.49, 95% CI 1.11-1.99, p = 0.008), liver metastasis (HR 1.58, 95% CI 1.09-2.28, p = 0.016), age (HR 1.38, 95% CI 1.02-1.88, p = 0.04) and white cell count (HR 1.40, 95% CI 1.01-1.95, p = 0.046) were independent factors facilitating OS prediction.
NLR and platelet count are poor prognostic factors for OS in patients with metastatic UC. The NPS model proves the excellent discriminating ability of OS.
Clinical trial identification
All authors have declared no conflicts of interest.