59 96
Table 4 – Risk factors for predicting on cancer-specific mortality following RNU in 394 patients
Univariate analyses
Multivariate analyses
Base model
Base model
plus NLR
Base model plus
plasma fibrinogen
Base model
plus serum CRP
Base model
plus CMS
HR (95% CI);
p
HR (95% CI);
p
HR (95% CI);
p
HR (95% CI);
p
HR (95% CI);
p
HR (95% CI);
p
Age at RNU (
>
70 vs 70 yr)
1.56 (1.01–2.41); 0.046
Sex (male vs female)
1.41 (0.89–2.25); 0.147
Tumor location (renal pelvis vs ureter)
0.91 (0.58–1.43); 0.695
Tumor grade (G3 vs G1/2)
3.26 (1.76–6.01);
<
0.001
Pathologic T stage,
p
for trend
<
0.001
<
0.001
<
0.001
<
0.001
<
0.001
<
0.001
pT2 vs pTa/1
2.52 (0.63–10.1); 0.191 1.85 (0.45–7.53); 0.393 1.81 (0.45–7.34); 0.408 1.90 (0.47–7.80); 0.371 1.82 (0.45–7.45); 0.403 2.21 (0.54–9.08); 0.274
pT3/4 vs pTa/1
13.5 (4.92–36.9);
<
0.001 7.70 (2.64–22.5);
<
0.001 7.25 (2.47–21.3);
<
0.001 7.40 (2.52–21.7);
<
0.001 8.35 (2.83–24.6);
<
0.001 8.83 (2.95–26.4);
<
0.001
Lymphovascular invasion
(positive vs negative)
5.12 (3.09–8.49);
<
0.001 2.44 (1.42–4.19); 0.001 2.42 (1.40–4.17); 0.002 2.41 (1.40–4.14); 0.002 2.06 (1.17–3.60); 0.012 2.06 (1.17–3.63); 0.012
Concomitant carcinoma in situ
(positive vs negative)
0.91 (0.53–1.58); 0.743
Adjuvant chemotherapy (yes vs no)
2.27 (1.45–3.55);
<
0.001
NLR (elevated vs not elevated)
2.01 (1.28–3.14); 0.002 –
1.71 (1.09–2.68); 0.019 –
–
–
Plasma fibrinogen (elevated vs not elevated) 2.16 (1.40–3.34);
<
0.001 –
–
1.85 (1.20–2.86); 0.006 –
–
Serum CRP (elevated vs not elevated)
2.39 (1.53–3.73);
<
0.001 –
–
–
2.11 (1.34–3.33); 0.001 –
CMS,
p
for trend
<
0.001
<
0.001
1 vs 0
1.41 (0.80–2.46); 0.236 –
–
–
–
1.13 (0.64–2.00); 0.669
2 vs 0
2.14 (1.15–3.99); 0.017 –
–
–
–
1.54 (0.82–2.89); 0.181
3 vs 0
4.42 (2.43–8.06);
<
0.001 –
–
–
–
4.07 (2.22–7,49);
<
0.001
Predictive accuracy, %
–
76.2
78.3
78.7
79.6
80.1
Mantel-Haenszel test
*–
–
0.022
0.006
0.002
<
0.001
CI = confidence interval; CMS = cumulative marker score; CRP = C-reactive protein; HR = hazard ratio; NLR = neutrophil-to-lymphocyte ratio; RNU = radical nephroureterectomy.
*
Compared with base model.
E U R O P E A N
U R O L O G Y
F O C U S
1
( 2 0 1 5
)
5 4 – 6 3
59