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Clinical significance of preoperative peripheral blood neutrophil count in patients with non-metastatic upper urinary tract carcinoma

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Abstract

Purpose

Preoperative elevation of markers of systemic inflammation is associated with a poor outcome in several cancers. The purpose of this study was to evaluate the prognostic significance of preoperative systemic inflammatory markers in patients with non-metastatic upper urinary tract cancer (UUTC).

Methods

The records of 84 patients with non-metastatic UUTC who had undergone nephroureterectomy were reviewed, and the associations between preoperative clinical variables and recurrence-free survival (RFS) were analyzed by univariate and multivariate analyses.

Results

Clinical tumor stage, neutrophil count, and neutrophil-to-lymphocyte ratio were significantly associated with RFS in univariate analysis. Multivariate analysis showed that clinical T stage (hazard ratio [HR], 3.009; 95 % confidence interval [CI], 1.149–9.321; p = 0.024) and neutrophil count (HR, 3.521; 95 % CI, 1.423–9.108; p = 0.007) were independent predictors of RFS. The 3-year RFS in patients with a neutrophil count <4,000/μL was significantly higher than that in patients with a neutrophil count ≥4,000/μL (82.9 vs. 51.0 %, p = 0.004). Based on clinical T stage (T2 or less vs. T3 or greater) and neutrophil count (<4,000 vs. ≥4,000/μL), patients were stratified into 3 groups: low, intermediate, and high risk groups. RFS rates were significantly different between the 3 groups (p = 0.0005).

Conclusions

Preoperative neutrophil count was an independent predictor of RFS in patients with non-metastatic UUTC. Stratification of patients based on neutrophil count and clinical T stage may be valuable for preoperative patient counseling and identifying patients with poor prognosis who may be candidates for neoadjuvant chemotherapy.

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Acknowledgments

This study was partially supported by the “Strategic Research-Based Support” Project for private universities with matching funds from MEXT (Ministry of Education, Culture, Sports, and Science), Japan.

Conflict of interest

No author has any financial disclosures or conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Urology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 1600023, Japan

    Takeshi Hashimoto, Yoshio Ohno, Jun Nakashima, Tatsuo Gondo, Makoto Ohori & Masaaki Tachibana

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  1. Takeshi Hashimoto
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  2. Yoshio Ohno
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  3. Jun Nakashima
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  4. Tatsuo Gondo
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  5. Makoto Ohori
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  6. Masaaki Tachibana
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Correspondence to Yoshio Ohno.

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Hashimoto, T., Ohno, Y., Nakashima, J. et al. Clinical significance of preoperative peripheral blood neutrophil count in patients with non-metastatic upper urinary tract carcinoma. World J Urol 31, 953–958 (2013). https://doi.org/10.1007/s00345-012-0942-x

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  • DOI: https://doi.org/10.1007/s00345-012-0942-x

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