Vartolomei MD, et al. - In order to assess the prognostic potential of the preoperative neutrophil-to-lymphocyte ratio (NLR), the authors have analyzed the current evidence regarding the prognostic significance of preoperative NLR in patients undergoing radical nephroureterectomy (RNU) for upper-tract urothelial carcinoma (UTUC). Results suggest that preoperative blood-based NLR is related to worse prognosis in patients undergoing RNU for UTUC. Clinical decision making related to RNU compared with kidney-sparing surgery, the extent of lymphadenectomy, perioperative systemic therapy and follow-up schedule can be improved by using NLR.