Prognostic Value of Baseline Neutrophil-to-Lymphocyte Ratio and Clinicopathological Factors in a Multicenter Cohort of Urothelial Carcinoma Treated with Adjuvant Nivolumab.

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2026-10-05 DOI:10.1159/uin/aewag032

Asuka Sano, Yuya Oishi, Gaku Ishikawa, Shunsuke Watanabe, Shinya Watanabe, Yoshihiro Tsuchiya, Ryoichi Maenosono, Yuki Yoshikawa, Kyosuke Nishio, Hirofumi Morinaka, Masanobu Saruta, Wataru Fukuokaya, Kyohei Watanabe, Hiromitsu Watanabe, Keita Tamura, Daisuke Motoyama, Takafumi Yanagisawa, Kiyoshi Takahara, Yutaka Yamamoto, Kazutoshi Fujita, Teruo Inamoto

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引用次数: 0

Abstract

Background: Adjuvant nivolumab prolongs disease-free survival (DFS) after radical surgery for high-risk urothelial carcinoma (UC), yet recurrence remains common. We investigated the prognostic impact of clinical and systemic inflammatory factors in these patients.

Methods: We retrospectively analyzed 127 patients who received adjuvant nivolumab following radical surgery at six institutions between April 2022 and January 2026. Prognostic factors for DFS were evaluated using Cox proportional hazards regression models.

Results: The median follow-up was 12.0 months, and DFS events occurred in 43.3% of patients. In the multivariable analysis, advanced pathological T stage (pT3-4 vs. pT1-2) (HR [hazard ratio], 2.525; 95% CI [confidence interval], 1.067-5.979) and baseline neutrophil-to-lymphocyte ratio (NLR) (HR, 1.216 per 1 unit increase; 95% CI, 1.034-1.430; p = 0.018) emerged as independent predictors of inferior DFS. Additionally, female sex showed an independent association with shorter DFS (HR, 0.275; 95% CI, 0.152-0.495; p < 0.001, though this finding warrants cautious interpretation given baseline characteristics and the small proportion of female patients.

Conclusions: Baseline NLR and advanced pT stage serve as valuable independent prognostic factors for patients receiving adjuvant nivolumab. Although interpreted with caution regarding specific subgroups and retrospective limitations, these findings highlight key risk factors in this setting and provide a rationale for larger prospective validation.

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中性粒细胞与淋巴细胞的基线比率和临床病理因素在辅助纳武单抗治疗的多中心尿路上皮癌队列中的预后价值

背景：辅助纳武单抗延长了高风险尿路上皮癌（UC）根治性手术后的无病生存期（DFS），但复发仍然很常见。我们研究了这些患者的临床和全身炎症因子对预后的影响。方法：我们回顾性分析了2022年4月至2026年1月期间在6家机构接受根治性手术后接受辅助纳武单抗治疗的127例患者。采用Cox比例风险回归模型评估DFS的预后因素。结果：中位随访时间为12.0个月，43.3%的患者发生DFS事件。在多变量分析中，晚期病理性T分期（pT3-4 vs pT1-2）（HR[危险比]，2.525；95% CI[置信区间]，1.067-5.979）和基线中性粒细胞与淋巴细胞比值（NLR）（HR， 1.216 / 1单位增加；95% CI, 1.034-1.430; p = 0.018）成为较差DFS的独立预测因子。此外，女性与较短的DFS有独立关联（HR, 0.275; 95% CI, 0.152-0.495; p < 0.001），但考虑到基线特征和女性患者比例小，这一发现需要谨慎解释。结论：基线NLR和晚期pT是接受纳武单抗辅助治疗的患者有价值的独立预后因素。尽管对特定亚组和回顾性限制的解释要谨慎，但这些发现强调了这种情况下的关键风险因素，并为更大规模的前瞻性验证提供了依据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.