Abstract

Background: Increasing neutrophil-to-lymphocyte ratio (NLR) is recognized to be correlated to the survival of patients with cancer. The predictive significance of NLR, corresponding to prognosis, among bladder carcinoma patients remains inconsistent.

Aim: To assess pre-treatment NLR as an oncological prognostic value for bladder carcinoma patients.

Methods: Relevant studies from databases of Medline/PUBMED, EMBASE and The Cochrane Controlled Trials Register were searched systematically. Hazard ratios (HRs) and confidence intervals (CIs) of 95% were applied to assess the correlations of high vs low pre-treatment NLR for both Cause Specific Survival (CSS) and Recurrence Free Survival (RFS). Multiple variables were analysed accordingly by utilizing STATA (version 13.0) for Windows.

Result: Fourteen studies encompassing a total of 10,184 patients were gathered to assess predictive significance, seen from the CSS and RFS, of pre-treatment NLR amongst Bladder Carcinoma patients. Overall, high pre-treatment NLR predicted worse CSS, as HR = 1.32 (95% CI: 1.16-1.49, P < 0.00), while on RFS, HR = 1.49 (95% CI: 1.26-1.76, P < 0.00).

Conclusion: This meta-analysis indicated that there is a significant correlation between elevated pre-treatment NLR and predicted worse prognosis according to cancer specific survival and the recurrence risk of the disease. The prognostic role of NLR may become a valuable indicator to improve clinical decision in bladder cancer patients.

Keywords: Bladder Cancer, Neutrophil to Lymphocyte Ratio, Prognostic