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.