Prognostic value of preoperative hematologic biomarkers in urothelial carcinoma of the bladder treated with radical cyst
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REVIEW ARTICLE
Prognostic value of preoperative hematologic biomarkers in urothelial carcinoma of the bladder treated with radical cystectomy: a systematic review and meta‑analysis Keiichiro Mori1,2 · Noriyoshi Miura1,3 · Hadi Mostafaei1,4 · Fahad Quhal1,5 · Reza Sari Motlagh1 · Ivan Lysenko1 · Shoji Kimura2 · Shin Egawa2 · Pierre I. Karakiewicz6 · Shahrokh F. Shariat1,7,8,9,10,11,12,13 Received: 29 December 2019 / Accepted: 27 April 2020 © The Author(s) 2020
Abstract This systematic review and meta-analysis aimed to assess the prognostic value of preoperative hematologic biomarkers in patients with urothelial carcinoma of the bladder treated with radical cystectomy. PUBMED, Web of Science, Cochrane Library, and Scopus databases were searched in September 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared cancer-specific survival in patients with urothelial carcinoma of the bladder with and without pretreatment laboratoryabnormalities. Formal meta-analyses were performed for this outcome. The systematic review identified 36 studies with 23,632 patients, of these, 32 studies with 22,224 patients were eligible for the meta-analysis. Several preoperative hematologic biomarkers were significantly associated with cancer-specific survival as follows: neutrophil − lymphocyte ratio (pooled hazard ratio [HR]: 1.20, 95% confidence interval [CI]: 1.11–1.29), hemoglobin (pooled HR: 0.87, 95% CI 0.82–0.94), C-reactive protein (pooled HR: 1.44, 95% CI 1.26–1.66), De Ritis ratio (pooled HR: 2.18, 95% CI 1.37–3.48), white blood cell count (pooled HR: 1.05, 95% CI 1.02–1.07), and albumin-globulin ratio (pooled HR: 0.26, 95% CI 0.14–0.48). Several pretreatment laboratory abnormalities in patients with urothelial carcinoma of the bladder were associated with cancer-specific mortality. Therefore, it might be useful to incorporate such hematologic biomarkers into prognostic tools for urothelial carcinoma of the bladder. However, given the study limitations including heterogeneity and retrospective nature of the primary data, the conclusions should be interpreted with caution. Keywords Urothelial carcinoma of the bladder · Hematologic biomarker · Meta-analysis * Shahrokh F. Shariat [email protected] 1
Department of Urology, Medical University of Vienna, Währinger Gürtel 18‑20, 1090 Vienna, Austria
2
Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
3
Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan
4
Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
5
Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
6
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada
7
Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
8
Department of Urology, Weill Cornell Medical Colle
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