Evidence map›Paper›PMID 24918819›Full record

ArticleBritish journal of cancer2014

Pre-treatment neutrophil-to-lymphocyte ratio as predictor of adverse outcomes in patients undergoing radical cystectomy for urothelial carcinoma of the bladder.

T Hermanns, B Bhindi, Y Wei, J Yu, A P Noon, P O Richard, J R Bhatt, A Almatar, M A S Jewett, N E Fleshner and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of cancer, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed, 9 pooled it
16.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 9 syntheses or guidelines pooled it, 107 citations in OpenAlex.

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  18. The Urinary Microbiome in Health and Disease: Relevance for Bladder Cancer.International journal of molecular sciences · 2024
    Review
  19. Article
  20. Bladder cancer, inflammageing and microbiomes.Nature reviews. Urology · 2022
    Review

2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

T Hermanns1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
B Bhindi1] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.
Y WeiDivision of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
J YuDivision of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
A P Noon1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
P O Richard1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
J R Bhatt1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
A Almatar1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
M A S Jewett1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
N E Fleshner1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
A R Zlotta1] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Department of Urology, Mount Sinai Hospital, 60 Murray Street, Toronto, Ontario, Canada M5T 3L9.
A J TempletonDivision of Medical Oncology, Department of Medicine, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9.
G S Kulkarni1] Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [2] Division of Urology, Department of Surgery, University Health Network, University of Toronto, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9 [3] Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.
Princess Margaret Cancer Centre · CAUniversity Health Network · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAn elevated neutrophil-to-lymphocyte ratio (NLR) is associated with poor outcome in various tumours. Its prognostic utility in patients with urothelial carcinoma of the bladder (UCB) undergoing radical cystectomy (RC) is yet to be fully elucidated.

methodsA cohort of patients undergoing RC for UCB in a tertiary referral centre between 1992 and 2012 was analysed. Neutrophil-to-lymphocyte ratio was computed using complete blood counts performed pre-RC, or before neo-adjuvant chemotherapy where applicable. Time-dependent receiver operating characteristic curves were used to determine the optimal cutoff point for predicting recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS). The predictive ability of NLR was assessed using Kaplan-Meier analyses and multivariable Cox proportional hazards models. The likelihood-ratio test was used to determine whether multivariable models were improved by including NLR.

resultsThe cohort included 424 patients followed for a median of 58.4 months. An NLR of 3 was determined as the optimal cutoff value. Patients with an NLR⩾3.0 had significantly worse survival outcomes (5y-RFS: 53% vs 64%, log-rank P=0.013; 5y-CSS: 57% vs 75%, log-rank P<0.001; 5y-OS: 43% vs 64%, log-rank P<0.001). After adjusting for disease-specific predictors, an NLR ⩾3.0 was significantly associated with worse RFS (HR=1.49; 95% CI=1.12-2.0, P=0.007), CSS (HR=1.88; 95% CI=1.39-2.54, P<0.001) and OS (average HR=1.67; 95% CI=1.17-2.39, P=0.005). The likelihood-ratio test confirmed that prognostic models were improved by including NLR.

conclusionsNeutrophil-to-lymphocyte ratio is an inexpensive prognostic biomarker for patients undergoing RC for UCB. It offers pre-treatment prognostic value in addition to established prognosticators and may be helpful in guiding treatment decisions.

Indexed as

AgedCarcinoma, Transitional CellCystectomyDisease-Free SurvivalFemaleHumansKaplan-Meier EstimateLymphocyte CountLymphocytesMaleMiddle AgedNeutrophilsPreoperative PeriodPrognosisProportional Hazards ModelsRetrospective Studies

Identifiers

PMID24918819
PMCPMC4119979
OpenAlexW2028944115

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.