A retrospective study on the possible systematic inflammatory response markers to predict the prognosis of patients with bladder cancer undergoing radial cystectomy

Recent studies have shown that several inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), lymphocyte-to-platelet ratio (LPR), De Retis and prognostic nutritional index (PNI), can function as useful prognostic factors in a number of malignancies. The present study aimed to assess the most reliable inflammatory tumor marker in patients with bladder cancer who have undergone radical cystectomy. A total of 161 cases underwent radical cystectomy between 1994 and 2014 at Yokohama City University Medical Center (Yokohama, Japan). Of these patients, the 107 who had data for the NLR, MLR, LPR, De Retis and PNI were enrolled in the present study. The correlation between recurrence-free survival (RFS) or overall survival (OS) and inflammatory tumor markers were examined. Regarding the RFS, the only noteworthy finding was that a lower PNI was associated with a significantly poorer RFS compared with higher PNI (P=0.028). Regarding the OS, lower LPR and PNI were associated with a significantly poorer OS compared with higher values (P=0.048 and P=0.036, respectively). The present study revealed that a low PNI more accurately predicts a worse RFS and OS compared with other systemic inflammatory risk factors.