Preoperative neutrophil-to-lymphocyte ratio (NLR) value as a predictor of recurrence of non-muscle-invasive bladder cancer

To predict oncological outcomes and select appropriate treatments for non-muscle-invasive bladder cancer (NMIBC), pre-treatment predictors such as neutrophil-to-lymphocyte ratio (NLR) are being used. This study aims to evaluate whether NLR is an independent predictor of disease and disease recurrence in NMIBC patients. In this prospective clinical study, from March 2018 to March 2023, preoperative NLR values were monitored in 99 patients newly diagnosed with NMIBC, who were initially treated with trans-urethral resection of bladder tumor (TURBT) and adjuvant intravesical therapy. To evaluate the best NLR cutoff points to predict recurrence, the ROC (receiver operating characteristic) curve and the Youden index were used. The monitoring period was 24 months. With the cutoff value of NLR = 1.73, there is a statistically significant correlation (p = 0.008) between the NLR value and the increased risk of recurrence. Univariate and multivariate Cox regression analyses show the significant prognostic impact of NLR on the recurrence of the disease. The value of NLR > 1.73 is a significant preoperative predictor in risk assessment and will help with proper selection of treatment in the high- and intermediate-risk groups of patients.