High proliferation rate and TNM stage but not histomorphological subtype are independent prognostic markers for overall survival in papillary renal cell carcinoma

2019 ◽  
Vol 83 ◽  
pp. 212-223 ◽  
Author(s):  
Iris Polifka ◽  
Abbas Agaimy ◽  
Edwin Herrmann ◽  
Verena Spath ◽  
Lutz Trojan ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Prognostic Markers ◽  
Papillary Renal Cell Carcinoma ◽  
Proliferation Rate ◽  
Tnm Stage ◽  
High Proliferation Rate

Lymphopenia as an independent predictor of worse survival in papillary renal cell carcinoma.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 397-397
Author(s):  
Reza Mehrazin ◽  
Robert G. Uzzo ◽  
Alexander Kutikov ◽  
Jeffrey J. Tomaszewski ◽  
Serge Ginzburg ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Lymphocyte Count ◽  
Papillary Renal Cell Carcinoma ◽  
Absolute Lymphocyte Count ◽  
Tnm Stage ◽  
Comorbidity Index ◽  
Papillary Rcc

397 Background: Lymphopenia signifies inflammatory response and is an index of poor systemic immunity which can be associated with poor survival outcomes. The aim of this study was to evaluate the prognostic relevance of preoperative absolute lymphocyte count (ALC) in patients with papillary renal cell carcinoma (RCC). Methods: We retrospectively analyzed our institutional, prospectively maintained, renal cancer database and identified patients with pathologic diagnosis of papillary RCC after partial or radical nephrectomy. Patients with preoperative ALC value within 3 months prior to surgery were eligible for the study. ALC of 1,300 cells/µl was used as the cutoff value (our lowest laboratory reference value). We evaluated the correlation between ALC and age, gender, Charlson comorbidity index (CCI), pathologic T stage, nuclear grade, and overall TNM stage. Differences in overall survival (OS) by ALC status were assessed using the log−rank test. Cox proportional hazards modeling was used for multivariable analyses. Results: We identified 314 out of 2,732 patients with a pathologic diagnosis of papillary RCC after partial or radical nephrectomy from 1997 to 2013. Those undergoing multiple surgical procedures (multifocal or bilateral disease) or missing preoperative ALC were excluded from the study. A total 205 patients met inclusion criteria with a median follow up of 37.3 months. As a continuous variable, low absolute lymphocyte count was associated with higher pT stage (p=0.038), TNM stage (p=0.029) and older age (p=0.022). Lymphopenia below 1,300 cells/µl was also associated with pT stage (p=0.008) and TNM stage (p=0.018). On multivariable analysis, independent of stage, older age,and CCI, lymphopenia was associated with inferior overall survival (HR 2.1 [CI 1.1−4.03], p=0.037). Conclusions: In our series of patients with papillary renal cell carcinoma, lymphopenia was associated with lower overall survival independent of stage, age,and charlson comorbidity index. ALC significantly increases the accuracy of already established prognostic factors and can be helpful for patient counseling and design of clinical trials.

scholarly journals Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in papillary renal cell carcinoma patients after receiving curative surgery based on a retrospective cohort

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhilei Zhang ◽  
Yongbo Yu ◽  
Jilu Zheng ◽  
Mingxin Zhang ◽  
Haitao Niu
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Roc Curve Analysis ◽  
Decision Curve Analysis ◽  
Tnm System

Abstract Background Inflammatory response biomarkers have been studied as promising prognostic factors in renal cell carcinoma, but few studies have focused on papillary renal cell carcinoma (PRCC). This study was performed to evaluate the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) in PRCC patients. Methods In total, 122 postoperative PRCC patients selected from 366 non-clear cell renal cell carcinoma patients were enrolled from our institution between 2012 and 2020. The optimal cutoff value of the NLR was assessed by receiver operating characteristic (ROC) curve analysis, and the Kaplan–Meier method and Cox's proportional hazards regression models were performed to analyze the association of the NLR with overall survival (OS). In addition, the potential of tumor-node-metastasis (TNM) stage, the NLR and an NLR-TNM system to predict survival were compared with ROC curves, and clinical usefulness of the predicting models were assessed by decision curve analysis. Results A threshold value of 2.39 for the NLR for OS analysis was determined by ROC curve analysis. An NLR ≥ 2.39 was associated with a more advanced TNM stage (P < 0.01) and larger tumors (P < 0.05) than a low NLR, as well as pathological subtype II (P < 0.05), and the patients with a high NLR also exhibited significantly worse overall survival outcomes (P < 0.05). The NLR was determined to be a significant independent prognostic indicator by univariable and multivariable analyses (HR = 5.56, P < 0.05). Furthermore, TNM stage and the NLR were integrated, and the area under the curve (AUC) of for the NLR-TNM system was larger than that of for the TNM system when predicting overall survival (0.84 vs 0.73, P = 0.04). Decision curve analysis also demonstrated a better clinical value for the NLR-TNM model to predict the prognosis. Conclusion A high preoperative NLR was associated with poor clinical and pathologic parameters in patients with PRCC; moreover, the NLR was also an independent prognostic factor for the OS of patients with PRCC. The NLR-TNM system, which was a model that integrated the NLR with TNM staging, could improve the ability to predict overall survival.

scholarly journals Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in papillary renal cell carcinoma patients after receiving curative surgery based on a retrospective cohort

2020 ◽  
Author(s):  
Zhilei Zhang ◽  
Yongbo Yu ◽  
Jilu Zheng ◽  
Mingxin Zhang ◽  
Haitao Niu
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Tnm Stage ◽  
Neutrophil To Lymphocyte Ratio ◽  
Receiver Operating Curve ◽  
Tnm System ◽  
Lymphocyte Ratio

Abstract Background: Inflammatory response biomarkers have been studied as promising prognostic factors in renal cell carcinoma (RCC), but there were few studies focusing on the papillary renal cell carcinoma (PRCC), this study was performed to evaluate the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) in PRCC patients. Methods: Totally 90 PRCC patients after surgical treatment selected from 284 non-clear renal cell carcinoma (nccRCC) were enrolled from our institution between 2012 and 2019. The optimal cutoff value of NLR was assessed by receiver operating curve (ROC), Kaplan–Meier method and Cox's proportional hazards regression models were performed to analyze association of NLR to overall survival (OS). In addition, the abilities of tumor-node-metastasis (TNM) stage, NLR and NLR-TNM system in predicting survival were compared by ROC curves. Results: 2.39 as the threshold value of NLR was determined by ROC curve in evaluating OS. Patients with NLR≥2.39 were associated with advanced TNM stage (P＜0.001), larger tumors (P＜0.05) and hypoalbuminemia (P＜0.05) compared to the low NLR group, these patients were also significantly exhibited worse overall survival outcomes(P＜0.05). NLR was a significantly independent prognostic indicator by univariate and multivariate analyses (HR = 5.870, P＜0.05). Furthermore, TNM stage and NLR were integrated and the area under curve (AUC) of NLR-TNM system was larger than that of TNM system when predicting overall survival (0.801 VS 0.761), but there was no difference between them (P=0.413).Conclusion: A high preoperative NLR was associated with poor clinical and pathologic parameters of patients with PRCC, moreover, NLR was also an independent prognostic factor of OS for patients with PRCC. The model of NLR-TNM system integrated NLR with TNM stage could improve the ability of predicting overall survival.

scholarly journals Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in papillary renal cell carcinoma patients after receiving curative surgery based on a retrospective cohort

2020 ◽  
Author(s):  
Zhilei Zhang ◽  
Yongbo Yu ◽  
Jilu Zheng ◽  
Mingxin Zhang ◽  
Haitao Niu
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Roc Curve ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Roc Curve Analysis ◽  
Tnm System

Abstract Background: Inflammatory response biomarkers have been studied as promising prognostic factors in renal cell carcinoma (RCC), but few studies have focused on papillary renal cell carcinoma (PRCC). This study was performed to evaluate the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) in PRCC patients. Methods: In total, 90122 postoperative PRCC patients selected from 284 366 non-clear cell renal cell carcinoma (nccRCC) patients were enrolled from our institution between 2012 and 20192020. The optimal cutoff value of the NLR was assessed by receiver operating characteristic (ROC) curve analysis, and the Kaplan–Meier method and Cox's proportional hazards regression models were performed to analyze the association of the NLR with overall survival (OS). In addition, the potential of tumor-node-metastasis (TNM) stage, the NLR and an NLR-TNM system to predict survival were compared with ROC curves. Results: A threshold value of 2.39 for the NLR for OS analysis was determined by ROC curve analysis. An NLR≥2.39 was associated with a more advanced TNM stage (P<0.001) and larger tumors (P<0.05) than a low NLR, as well as pathological subtype Ⅱ (P<0.05), and the patients with a high NLR also exhibited significantly worse overall survival outcomes (P<0.05). The NLR was determined to be a significant independent prognostic indicator by univariable and multivariable analyses (HR = 5.557, P<0.05). Furthermore, TNM stage and the NLR were integrated, and the area under the curve (AUC) of for the NLR-TNM system was larger than that of for the TNM system when predicting overall survival (0.839 VS 0.731, P=0.036). Conclusion: A high preoperative NLR was associated with poor clinical and pathologic parameters in patients with PRCC; moreover, the NLR was also an independent prognostic factor for the OS of patients with PRCC. The NLR-TNM system, which was a model that integrated the NLR with TNM staging, could improve the ability to predict overall survival.

scholarly journals Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in papillary renal cell carcinoma patients after receiving curative surgery based on a retrospective cohort

2021 ◽  
Author(s):  
Zhilei Zhang ◽  
Yongbo Yu ◽  
Jilu Zheng ◽  
Mingxin Zhang ◽  
Haitao Niu
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Roc Curve Analysis ◽  
Decision Curve Analysis ◽  
Tnm System

Abstract Background: Inflammatory response biomarkers have been studied as promising prognostic factors in renal cell carcinoma (RCC), but few studies have focused on papillary renal cell carcinoma (PRCC). This study was performed to evaluate the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) in PRCC patients. Methods: In total, 122 postoperative PRCC patients selected from 366 non-clear cell renal cell carcinoma (nccRCC) patients were enrolled from our institution between 2012 and 2020. The optimal cutoff value of the NLR was assessed by receiver operating characteristic (ROC) curve analysis, and the Kaplan–Meier method and Cox's proportional hazards regression models were performed to analyze the association of the NLR with overall survival (OS). In addition, the potential of tumor-node-metastasis (TNM) stage, the NLR and an NLR-TNM system to predict survival were compared with ROC curves, and clinical usefulness of the predicting models were assessed by decision curve analysis. Results: A threshold value of 2.39 for the NLR for OS analysis was determined by ROC curve analysis. An NLR≥2.39 was associated with a more advanced TNM stage (P<0.01) and larger tumors (P<0.05) than a low NLR, as well as pathological subtype Ⅱ (P<0.05), and the patients with a high NLR also exhibited significantly worse overall survival outcomes (P<0.05). The NLR was determined to be a significant independent prognostic indicator by univariable and multivariable analyses (HR = 5.56, P<0.05). Furthermore, TNM stage and the NLR were integrated, and the area under the curve (AUC) of for the NLR-TNM system was larger than that of for the TNM system when predicting overall survival (0.84 VS 0.73, P=0.04). Decision curve analysis also demonstrated a better clinical value for the NLR-TNM model to predict the prognosis. Conclusion: A high preoperative NLR was associated with poor clinical and pathologic parameters in patients with PRCC; moreover, the NLR was also an independent prognostic factor for the OS of patients with PRCC. The NLR-TNM system, which was a model that integrated the NLR with TNM staging, could improve the ability to predict overall survival.

Clinical course of patients with metastatic papillary renal cell carcinoma

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14591-14591 ◽  
Author(s):  
T. Steiner ◽  
J. Roigas ◽  
H. Kirchner ◽  
C. Doehn ◽  
H. Heynemann ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Clinical Data ◽  
Metastatic Disease ◽  
Renal Cell ◽  
Clear Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Entire Study ◽  
Local Recurrences

14591 Background: For a long time it has been discussed, whether patients (pts.) with metastatic papillary renal cell carcinoma (mRCC pap) demonstrate different behaviour compared to those with clear cell mRCC. Methods: Clinical data of 61 pts. with mRCC pap were retrospectively assessed at 8 treatment centres. Results: Median follow-up was 20 (1–114) months, median age at time of diagnosis was 62 (24–85) years. Men were affected predominantly (50/61 pts.; 82%). 21 pts. (34%) showed metastases at time of diagnosis. The remaining 40 pts. had metachroneous metastatic disease. Mean time to metastases development was 30.4 (3–143; median 16.5) months. Metastatic sites were: lung (37; 61%), bone (24; 38%), liver (20; 33%), lymph nodes (24; 38%). Local recurrences occurred in 17 pts. (28%). Others sites of metastatic disease were brain in 6 pts. (10%), peritoneal carcinosis in 5 pts. (8%) and others. A surgical approach was performed primarily in 11 pts. (18%): lung 2; local recurrence and lymphomas 7; liver 1; brain 1. 26/61 pts. with metastatic disease received an immuno- (interferon-a ± interleukin-2) or immunochemotherapy (in combination with vinblastine or 5-fluorouracile) as first line treatment. In total, 42/61 pts. (69%) received an interferon- or interleukin-based immunotherapy. No treatment at all was performed in 12 pts. (20%) because of poor performance status. 5/42 pts. (11.4%) achieved an objective response to immuno(chemo)therapy. In the Kaplan-Meier-analysis, median overall survival after diagnosis of metastatic disease was estimated to be 13 ± 1.5 (95% CI 9.9–16) months for the entire study group and 12 ± 2.5 (95% CI 7.1–16.3) from the beginning of systemic treatment. Conclusions: Clinical data of a large population of pts. with mRCC pap have been assessed in this retrospective analysis for the first time. Compared to pts. with clear cell mRCC, these patients are characterized by: I) more frequent local recurrences; II) lower remission rates to immuno(chemo)therapeutic approaches; III) poorer prognosis with regard to overall survival. These findings should be taken into account when planning future studies. No significant financial relationships to disclose.

Differential expression of prognostic markers in histological subtypes of papillary renal cell carcinoma

2008 ◽  
Vol 102 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Anne Gentil Perret ◽  
Alix Clemencon ◽  
Guorong Li ◽  
Jacques Tostain ◽  
Michel Peoc’h
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Differential Expression ◽  
Renal Cell ◽  
Prognostic Markers ◽  
Papillary Renal Cell Carcinoma ◽  
Histological Subtypes

scholarly journals Development and validation of a nomogram for predicting overall survival in papillary renal cell carcinoma: a retrospective cohort study

2020 ◽  
Author(s):  
Jiawu Wang ◽  
Chengyao Zhang ◽  
Yanjun Lin ◽  
Qing Jiang
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Renal Tumors ◽  
Seer Database ◽  
Prognosis Prediction ◽  
7Th Edition ◽  
Tumor Node Metastasis Stage

Abstract Background Papillary RCC (PRCC) is the second most common pathological subtype after clear cell RCC (ccRCC), representing 10–20% of treatment of renal tumors. The aim of this study was to establish a reliable nomogram model to evaluate the prognosis of papillary renal cell carcinoma (PRCC) for overall survival (OS). Patients and methods : In total, 6,028 patients with PRCC from the Surveillance, Epidemiology, and End Results (SEER) database were randomly separated into training (n = 4,220) and validation (n = 1,808) cohorts. Cox regression analyses were used to identify the significant variables. A nomogram was established to predict the prognosis of an individual patient with PRCC in terms of OS based on the Cox model. The predictive accuracy of the nomogram model was assessed via discrimination and calibration plots. Results Data of 6,028 patients with PRCC were retrieved from the SEER database. Age at diagnosis, grade, Tumor-Node-Metastasis stage (TNM, AJCC, 7th edition), surgical treatment, tumor number and marital status were the significant independent prognostic variables. All variables were combined to establish a nomogram. Compared to the TNM stage system 7th edition, our nomogram exhibited a favorable discrimination power for OS prediction both in the training and validation cohorts. The calibration curves revealed high consistency between the prognosis prediction of our nomogram and the actual survival. Conclusions The nomogram displayed a excellent performance, suggesting that it could be considered an effective and individualized tool for prognosis prediction of OS in patients with PRCC.

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