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Pretreatment lymphocyte–monocyte ratio as a potential prognostic factor in a cohort of patients with upper tract urothelial carcinoma
  1. Georg C Hutterer1,
  2. N Sobolev1,
  3. Georg C Ehrlich1,
  4. Thomas Gutschi1,
  5. Tatjana Stojakovic2,
  6. Sebastian Mannweiler3,
  7. Karl Pummer1,
  8. Richard Zigeuner1,
  9. Martin Pichler4,5,
  10. Orietta Dalpiaz1
  1. 1Department of Urology, Medical University of Graz, Graz, Austria
  2. 2Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
  3. 3Institute of Pathology, Medical University of Graz, Graz, Austria
  4. 4Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
  5. 5Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Martin Pichler, Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz A-8036, Austria; martin.pichler{at}


Aims To investigate the potential prognostic impact of the lymphocyte–monocyte ratio (LMR) in a large European cohort of patients with localised upper urinary tract urothelial carcinoma (UTUC). The LMR as an indicator of systemic inflammatory response has been shown to represent a potential prognostic factor in various types of human cancers. Up to date, the prognostic significance of the LMR in UTUC has not been evaluated.

Methods Clinico-pathological data from 182 non-metastatic patients with UTUC, operated between 1990 and 2012 at a single tertiary academic centre, were evaluated retrospectively. Pretreatment LMR was assessed 1 day before surgery. Patients were categorised using an LMR cut-off value of 2.0 according to a calculation by receiver-operating curve analysis. Patients’ overall survival (OS) was assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of the LMR, a multivariate proportional Cox regression model was applied for OS.

Results In multivariate analyses, age on the date of surgery (<65 vs ≥65 years, HR=2.10, 95% CI 1.22 to 3.64), pathological T-stage (pT1 vs pT2–4, HR=2.15, 95% CI 1.26 to 3.67), as well as the LMR (<2 vs ≥2, HR=0.56, 95% CI 0.35 to 0.92) were independent predictors of OS of patients with UTUC.

Conclusions In the cohort studied, patients with an elevated (≥2) preoperative LMR had a subsequently longer OS after radical surgery for UTUC, compared with those with a low (<2) preoperative LMR. Thus, we believe this parameter might be considered an additional prognostic factor in UTUC in the future.


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