Preoperative NLR value as a predictor of recurrence of non-muscle-invasive bladder cancer

Abstract Purpose: 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. Methods: In this prospective clinical study, from March 2018 - 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 cut-off points to predict recurrence, the ROC (receiver operating characteristic) curve and the Youden index were used. The monitoring period was 24 months. Results: With the cut-off 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 analysis show the significant prognostic impact of NLR on the recurrence of the disease. Conclusion: The value of NLR>1.73 is a significant preoperative predictor in risk assessment and will help with proper selection of treatment in high-risk group patients.