Relationship Between Lymph Node Metastasis and Lymph Node Density and Preoperative Neutrophil-Lymphocyte Ratio in Patients Undergoing Radical Cystectomy

Objective: This study aimed to evaluate the relationship between the preoperative neutrophil-lymphocyte ratio (NLR) and lymph node metastasis and lymph node density after radical cystectomy in patients with invasive urinary bladder cancer. Materials and Methods: Data of 89 patients who underwent radical cystectomy were examined. Our study included only cases with stage 2 urothelial bladder cancer. They were classified according to the lymph node status based on the surgical specimen. Patients with negative results were classified as group 1 and those with positive results as group 2. Patients in group 2 were further evaluated in two subgroups according to their lymph node density. Accordingly, group 2A consisted of patients with lymph node density of <20%, and group 2B involved those with lymph node density of >= 20%. Groups were compared statistically according to NLR. Results: Of the patients, 71 (79.8%) were male. The patients' mean ages and neutrophil and lymphocyte counts were 67.36 +/- 8.64 years, 6.89 +/- 3.02 K/mu L, and 3.08 +/- 2.18 K/mu L, respectively. NLRs of groups 1 and 2 were 2.80 +/- 2.25 and 4.59 +/- 2.97, respectively. The relationship between group 1 and 2 tumors was significant (p=0.008). NLR values were 3.82 +/- 2.49 and 5.20 +/- 3.25 in groups 2A and 2B, respectively. However, no significant relationship was found between these values (p=0.235). Conclusion: Although no positive correlation was found between NLR and lymph node density, we think that this inflammation marker is an invaluable parameter to predict lymph node metastasis.