Preoperative Neutrophil-to-Lymphocyte Ratio Was a Predictor of Overall Survival in Small Renal Cell Carcinoma: An Analysis of 384 Consecutive Patients

Objective. The aim of this study was to investigate the prognostic significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) in small renal cell carcinoma (sRCC, ≤4 cm). Methods. This study was approved by the review board (NO.XYFY2019-KL032-01). Between 2007 and 2016, a total of 384 consecutive patients who underwent curative surgery for sRCC at our institution were evaluated. Patients were divided into high NLR and low NLR groups by plotting the NLR receiver operating characteristic curve. The Kaplan–Meier method was utilized to graphically display survivor functions. Univariate and multivariate Cox proportional hazards regression analysis addressed time to overall survival (OS) and cancer-specific survival (CSS). Results. Of the 384 patients, 264 (68.8%) were males and 120 (31.2%) were females. Median follow-up time after surgical resection was 54 months. One hundred and eighty-seven (48.7%) patients had a high NLR (≥1.97), and the remaining 197 (51.3%) had a low NLR (<1.97). Patients with high NLR were more likely to be aged compared with patients with low NLR (P=0.028). High NLR was associated with decreased OS and CSS compared with low NLR (P=0.002, P=0.065, respectively, the log-rank test). Multivariate Cox model analysis showed that the high NLR was an independent prognostic factor for OS (hazard ratio: 3.145, 95% confidence interval: 1.158–8.545, P=0.025). Conclusions. Elevated preoperative NLR is an independent adverse prognostic factor for OS after surgery with curative intent for sRCC.

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Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Nonmetastatic Renal Cell Carcinoma: A Large, Multicenter Cohort Analysis

BioMed Research International ◽

10.1155/2016/5634148 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Seok-Soo Byun ◽

Eu Chang Hwang ◽

Seok Ho Kang ◽

Sung-Hoo Hong ◽

Jinsoo Chung ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Prognostic Factor ◽

Cell Carcinoma ◽

Renal Cell ◽

Group Performance ◽

Cohort Analysis ◽

Prognostic Significance ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Multicenter Cohort

Background. The prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) in nonmetastatic renal cell carcinoma (non-mRCC) is controversial, although NLR has been established as a prognostic factor in several cancers. The objective of our study was to assess the prognostic significance of preoperative NLR in non-mRCC, based on a large, multicenter cohort analysis. Methods. Totally, 1,284 non-mRCC patients undergoing surgery were enrolled from six institutions between 2000 and 2014. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were calculated, and the prognostic significance of NLR was evaluated. Results. Patients with higher NLR had larger tumors (p<0.001), higher T stage (p<0.001), worse Eastern Cooperative Oncology Group performance status (p<0.001), worse symptoms (p=0.003), sarcomatoid differentiation (p=0.004), and tumor necrosis (p<0.001). The 5-year RFS and CSS rates were significantly lower in patients with high NLR than in those with low NLR (each p<0.001). Multivariate analysis identified NLR to be an independent predictor of RFS and CSS (each p<0.05). Moreover, predictive accuracy of multivariate models for RFS and CSS increased by 2.2% and 4.2%, respectively, with NLR inclusion. Conclusions. Higher NLR was associated with worse clinical behavior of non-mRCC. Also, NLR was a significant prognostic factor of both RFS and CSS.

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Validation of the pretreatment neutrophil-lymphocyte ratio as prognostic factor regarding cancer-specific, metastasis-free, and overall survival in a European cohort of patients with renal cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.410 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 410-410 ◽

Cited By ~ 1

Author(s):

Georg C. Hutterer ◽

Martin Pichler ◽

Caroline Stoeckigt ◽

Thomas F. Chromecki ◽

Tatjana Stojakovic ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Prognostic Factors ◽

Prognostic Factor ◽

Cell Carcinoma ◽

Renal Cell ◽

Prognostic Significance ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Metastatic Rcc

410 Background: The neutrophil-lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammation response and data from previous studies report controversial results about its independent prognostic role in non-metastatic renal cell carcinoma (RCC). Thus, we decided to evaluate the prognostic significance of NLR in a large cohort of RCC patients. Methods: Data from 843 consecutive non-metastatic RCC patients, operated with radical nephrectomy or nephron sparing surgery between 2000 and 2010 at a single tertiary academic center, were evaluated retrospectively. Pre-treatment NLR was calculated one day before surgical intervention. Patients were categorized according to a NLR cut-off value of 3.2. Cancer-specific–, metastasis-free–, as well as overall survival were assessed using the Kaplan-Meier method. To evaluate NLR’s independent prognostic significance, a multivariate Cox regression model was performed for all three endpoints. Results: An increased NLR was associated with several well established prognostic factors including tumor size, tumor grade, and histologic tumor necrosis (all p<0.05). Although an increased NLR was statistically significantly associated with poor outcome for all clinical endpoints (p<0.001), multivariate analysis identified an increased NLR as an independent prognostic factor for overall (HR=1.58, 95% CI=1.12-2.20, p=0.008), but not for cancer-specific (HR=1.55, 95% CI=0.89-2.70, p=0.116), nor for metastasis-free survival (HR=1.37, 95% CI=0.88-2.14, p=0.160). Conclusions: Risk prediction for cancer-related endpoints using NLR does not seem to add independent prognostic information to other well established prognostic factors in patients with non-metastatic RCC. Regarding patients’ overall survival, an increased NLR represented an independent risk factor, which might reflect a higher risk for cardiovascular, infectious, as well as for gastrointestinal morbidities and mortalities.

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