Benefit from cytoreductive nephrectomy and the prognostic role of neutrophil-to-lymphocyte ratio in patients with metastatic renal cell carcinoma

2016 ◽  
Vol 46 (11) ◽  
pp. 1291-1297 ◽  
Author(s):  
D. Day ◽  
Y. Kanjanapan ◽  
E. Kwan ◽  
D. Yip ◽  
N. Lawrentschuk ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cytoreductive Nephrectomy ◽  
Prognostic Role ◽  
Lymphocyte Ratio

Can neutrophil-to-lymphocyte ratio be used to identify patients with metastatic renal cell carcinoma who may gain greater benefit from cytoreductive nephrectomy?

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 490-490
Author(s):  
Daphne Dai ◽  
Yada Kanjanapan ◽  
Edmond Michael Kwan ◽  
Desmond Yip ◽  
Nathan Lawrentschuk ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Multivariate Analyses ◽  
De Novo ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cytoreductive Nephrectomy ◽  
Lymphocyte Ratio ◽  
The Impact

490 Background: Two randomized trials demonstrated survival benefits associated with cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma (mRCC) in the interferon era. However, the role of CN in the era of targeted therapies is yet to be defined. In recent years, neutrophil-to-lymphocyte ratio (NLR) has emerged as a clinically useful prognostic marker in several cancers including mRCC. In this multi-center retrospective study, we aim to assess the impact of CN in mRCC and the value of NLR in risk stratification and patient selection. Methods: Patients with de novo mRCC diagnosed between 2006 and 2012 from three large Australian hospitals were identified using an electronic database. Data regarding clinicopathological features, MSKCC risk group, NLR at the time of metastatic diagnosis, treatments received and survival were collected. NLR ≥5 was used as the cutoff for statistical analyses. Survival analyses were performed using the Kaplan-Meier method and compared using the log-rank test. Multivariate analyses used the Cox proportional hazards method. Results: Our study identified 91 de novo mRCC patients. CN was performed in 46 (51%) patients. Patients who underwent CN were more likely to be younger (median age 59.0 vs. 64.6, p=0.019), and to have received systemic therapy post CN (91% vs. 76%, p=0.043). Median overall survival (mOS) was significantly improved in patients who underwent CN (23.0 mo vs. 10.9 mo, p=0.039). Patients with NLR <5 also had superior mOS (16.7 mo vs. 6.2 mo; HR 0.53; 95% CI; 0.24-0.84; p=0.013). While CN was associated with substantially improved survival in patients with both NLR <5 (mOS 31.1 mo vs. 7.0 mo; HR 0.41; 95% CI, 0.18-0.64; p=0.0009) and NLR ≥5 (mOS 10.9 mo vs. 2.3 mo; HR 0.33; 95% CI, 0.11-0.69; p=0.009), the absolute survival difference was greater in patients with baseline NLR <5. Significant survival benefits associated with CN were maintained in multivariate analyses (HR 0.31; 95% CI, 0.18-0.55; p<0.0001). Conclusions: CN is associated with significantly improved OS in de novo mRCC. The incremental survival benefit associated with CN was seen irrespective of NLR.

Prognostic role of hematologic parameters of metastatic renal cell carcinoma treated with sunitinib

2021 ◽  
pp. 030089162110339
Author(s):  
Elena Bolzacchini ◽  
Monica Giordano ◽  
Lorenza Bertù ◽  
Marco Bregni ◽  
Olga Nigro ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Multivariate Analysis ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Clinical Data ◽  
Renal Cell ◽  
Prognostic Role ◽  
Lymphocyte Ratio ◽  
Poor Risk

Background: Hemochrome parameters at the diagnosis of metastatic renal cell carcinoma (mRCC) and the development of macrocytosis during sunitinib therapy are considered prognostic. Objective: To evaluate the prognostic role of hematologic parameters and macrocytosis in mRCC treated with sunitinib. Methods: We analyzed clinical data of 100 patients with mRCC treated with sunitinib as first-line therapy in a retrospective multicenter study. We calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) at baseline and erythrocyte mean corpuscular volume (MCV) during therapy. We considered the following cutoffs: NLR >3, PLR >150, LMR <3, and MCV >100 fl. Clinical data histology, prior nephrectomy, Fuhrman grading, metastatic sites, Memorial Sloan-Kettering Cancer Center score, and Heng score were collected. Overall survival (OS) and progression-free survival (PFS) were calculated. Univariate and multivariate analysis using Cox regression model with time-dependent (macrocytosis) covariate were applied. Results: At the univariate analysis, low LMR was associated with shorter PFS and OS ( p = 0.02 and p = 0.06, respectively). High PLR was associated with worse PFS ( p = 0.005); median OS was 23 vs 28 months ( p = 0.13). At the multivariate analysis, poor risk (Heng score), low LMR, and high PLR were associated with shorter PFS (hazard ratio 7.1, 1.5, and 2, respectively); poor PS and poor risk (Heng score) were related to worst OS. Macrocytosis was observed in 26 patients and was not prognostic of survival. Conclusions: In our cohort of patients with mRCC treated with sunitinib, low LMR (>3) and high PLR (>150) were associated with shorter PFS. Macrocytosis was not prognostic.

scholarly journals Prognostic Role of Circulating Tumor Cells ( CTCS ) in Metastatic Renal Cell Carcinoma: A Large, Multicenter Prospective Trial

2021 ◽  
Author(s):  
Umberto Basso ◽  
Antonella Facchinetti ◽  
Elisabetta Rossi ◽  
Marco Maruzzo ◽  
Vincenza Conteduca ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Prospective Trial ◽  
Prognostic Role

scholarly journals Current role of cytoreductive nephrectomy in metastatic renal cell carcinoma

2021 ◽  
Vol 47 (Supp1) ◽  
pp. S79-S84
Author(s):  
Charles Van Praet ◽  
◽  
Charlotte Slots ◽  
Nikhil Vasdev ◽  
Sylvie Rottey ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Cytoreductive Nephrectomy ◽  
Current Role
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