The prognostic value of the neutrophil-to-lymphocyte ratio in patients with testicular cancer.

To evaluate the potential prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in testicular cancer.

80 patients with testicular cancer treated at our institution from 2005 to 2018 were retrospectively reviewed. Age, tumor markers, stage and histotype at final pathology, eventual medical treatment, tumor recurrence and follow-up data were extracted. The NLR was retrospectively calculated from blood tests. Data were analyzed by medians comparison, linear correlation, univariate and multivariate Cox regression and survival curve analysis.

Population's median age was 33 years and median follow-up was 40.5 months. Overall, the median NLR was significantly reduced after orchiectomy (2.2 [1.55-3.09] vs. 1.77 [1.34-2.46], M-W P<0.001). Post-orchiectomy NLR was higher in patients who had disease recurrence (2.51;IQ 1.84-3.74 vs 1.59; IQ 1.10-2.24; M-W P=0.001), regardless of disease's stage: HR=1,85 (95%CI 0,99-3,46) and HR=1,91 (95%CI 0,96-3,78) for stage disease I or stage II, respectively. After stratification of patients by post-orchiectomy NLR (optimal cut-off: 2.255), patients with lower NLR had significantly longer recurrence-free survival (107.7 months [95%CI 97,7-119,2] vs. 57.65 months [95%CI 48,2-81,1], P<0.001). Univariable and multivariable Cox proportional hazard analyses, showed post-orchiectomy NLR, histotype at final pathology and disseminated disease at diagnosis as predictors of recurrence.

NLR is a simple and wildly available biomarker. Higher post-orchiectomy NLR was found independently correlated to higher risk of recurrence, regardless of disease stage, which could potentially lead to a worse prognosis.

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2020 Mar 20 [Epub ahead of print]

J L Bauzá Quetglas, A Tienza Fernández, R Bertolo, X A Sabaté Arroyo, J Guimerà García, V Tubau Vidaña, G Frontera Juan, E Pieras Ayala

Urology Department, Hospital Universitari Son Espases, No.79 Carretera de Valldemossa, 07010 Palma de Mallorca/Illes Balears, Spain. Electronic address: ., Urology Department, Hospital Universitari Son Espases, No.79 Carretera de Valldemossa, 07010 Palma de Mallorca/Illes Balears, Spain., Glickman Urological and Kidney Institute, Cleveland Clinic, Ohio, USA., Research Department, Hospital Universitari Son Espases, Illes Balears, Spain.

email news signup