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Neutrophil‐to‐lymphocyte ratio as a bladder cancer biomarker: Assessing prognostic and predictive value in SWOG 8710
Cancer, 2017-03, Vol.123 (5), p.794-801
Ojerholm, Eric
Smith, Andrew
Hwang, Wei‐Ting
Baumann, Brian C.
Tucker, Kai N.
Lerner, Seth P.
Mamtani, Ronac
Boursi, Ben
Christodouleas, John P.
2017
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Ojerholm, Eric
Smith, Andrew
Hwang, Wei‐Ting
Baumann, Brian C.
Tucker, Kai N.
Lerner, Seth P.
Mamtani, Ronac
Boursi, Ben
Christodouleas, John P.
Titel
Neutrophil‐to‐lymphocyte ratio as a bladder cancer biomarker: Assessing prognostic and predictive value in SWOG 8710
Ist Teil von
Cancer, 2017-03, Vol.123 (5), p.794-801
Ort / Verlag
United States: Wiley Subscription Services, Inc
Erscheinungsjahr
2017
Quelle
MEDLINE
Beschreibungen/Notizen
BACKGROUND Risk stratification is a major challenge in bladder cancer (BC), and a biomarker is needed. Multiple studies have reported the neutrophil‐to‐lymphocyte ratio (NLR) as a promising candidate; however, these analyses have methodological limitations. Therefore, the authors performed a category B biomarker study to test whether NLR is prognostic for overall survival (OS) after curative treatment or is predictive for the survival benefit from neoadjuvant chemotherapy (NAC). METHODS This study is an unplanned secondary analysis of SWOG 8710, a randomized phase 3 trial that assessed cystectomy with or without NAC in 317 patients with muscle‐invasive BC. NLR was calculated from prospectively collected complete blood counts. For the prognostic analysis, 230 patients were identified; for the predictive analysis, 263 were identified. NLR was evaluated with proportional hazards models including prespecified factors (age, sex, T‐stage, lymphovascular invasion, and treatment arm). RESULTS With a median follow‐up of 18.6 years, there were 172 and 205 deaths in the prognostic and predictive cohorts, respectively. In a multivariable analysis, NLR was not prognostic for OS (hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.98‐1.11; P = .24). Furthermore, NLR did not predict for the OS benefit from NAC (HR, 1.01; 95% CI, 0.90‐1.14; P = .86). Factors associated with worse OS were older age (HR, 1.05; 95% CI, 1.04‐1.07; P < .001) and surgery without NAC (HR, 1.39; 95% CI, 1.03‐1.88; P = .03). CONCLUSIONS This is the first analysis of NLR in BC to use prospectively collected clinical trial data. In contrast to previous studies, it suggests that NLR is neither a prognostic nor predictive biomarker for OS in muscle‐invasive BC. Cancer 2017;123:794–801. © 2016 American Cancer Society. This is the first category B biomarker study testing the neutrophil‐to‐lymphocyte ratio in bladder cancer. In contrast to previous reports, these data suggest that the neutrophil‐to‐lymphocyte ratio holds neither prognostic nor predictive value for overall survival.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.30422
Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5319875
Format
–
Schlagworte
Aged
,
biomarker
,
Biomarkers
,
Biomarkers, Tumor - blood
,
Bladder
,
Bladder cancer
,
Blood Cell Count
,
Cancer
,
Chemotherapy
,
Confidence intervals
,
Disease-Free Survival
,
Female
,
Follow-Up Studies
,
Hazard identification
,
Health risks
,
Humans
,
Invasiveness
,
Lymphocytes
,
Lymphocytes - pathology
,
Male
,
Middle Aged
,
Neoadjuvant Therapy
,
Neutrophils
,
Neutrophils - pathology
,
neutrophil‐to‐lymphocyte ratio (NLR)
,
Oncology
,
Patients
,
Prognosis
,
Secondary analysis
,
Surgery
,
Survival
,
Urinary bladder
,
Urinary Bladder Neoplasms - blood
,
Urinary Bladder Neoplasms - drug therapy
,
Urinary Bladder Neoplasms - pathology
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