Single center validation of neutrophil-to-lymphocyte ratio in localized and metastatic clear cell renal cell carcinoma.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 696-696
Author(s):  
Kevin Richard Melnick ◽  
Dattatraya H Patil ◽  
Amir Ishaq Khan ◽  
Frances Y Kim ◽  
Mersiha Torlak ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Kidney Cancer ◽  
Renal Cell ◽  
Validation Cohort ◽  
Clear Cell ◽  
Independent Predictor ◽  
Prognostic Scores ◽  
Clinicopathologic Features

696 Background: The neutrophil-to-lymphocyte ratio (NLR) has been evaluated as a serum marker of inflammation and oncologic prognosis. In renal cell carcinoma (RCC), a higher preoperative NLR is associated with aggressive clinicopathologic features and is an independent predictor of poor survival. This study builds upon our institution’s prior work with the NLR in metastatic RCC and examines a larger validation cohort that includes localized disease. It also compares the predictive power of the NLR to established kidney cancer prognostic scores. Methods: Our kidney cancer database provided patients with clear cell RCC who underwent nephrectomy from January 2001 to June 2017 and had a documented preoperative NLR within 15 days prior to surgery. The optimal threshold of NLR was determined using receiver operating characteristic (ROC) curve and sensitivity-specificity trade-off analysis. Kaplan-Meier curves and logistic regression analysis were performed to assess the significance and independence of preoperative NLR in predicting OS. Finally, the prognostic ability of NLR was compared to current prognostic scores through chi-square analysis of their respective c-indices. Results: The 441 patient cohort was comprised of 361 patients with localized and/or regional disease and 80 patients with distant metastases. NLR values among all participants ranged from 0.4 to 74.0 (median 3.1). ROC analysis defined an optimal preoperative NLR threshold of 3.5. On multivariate analysis, after adjusting for clinicopathologic features and distant metastatic disease, a NLR ≥ 3.5 was found to be a significant and independent predictor of overall survival (HR = 1.41, 95% CI 1.05-1.91 & p value = 0.024). Our data also revealed no statistically significant difference between the c-indices of NLR and the UISS, SSIGN, or Leibovich scores in predicting survival. Conclusions: In our validation cohort of patients with both metastatic and non-metastatic clear cell RCC, our data show that a preoperative NLR ≥ 3.5 is a significant and independent predictor of overall survival in patients undergoing nephrectomy and is comparable to other established prognostic tools in RCC.

Postoperative modified Glasgow prognostic score as an independent predictor of overall survival in clinically localized clear cell renal cell carcinoma.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 456-456
Author(s):  
Lindsey Allison Herrel ◽  
Caroline Gar-Ling Tai ◽  
Ruth Westby ◽  
Ken Ogan ◽  
Daniel Canter ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Independent Predictor ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Cell Renal Cell Carcinoma ◽  
Modified Glasgow Prognostic Score

456 Background: Renal cell carcinoma (RCC) demonstrates heterogeneous behavior. Approximately 30% to 40% of patients with clinically localized RCC will later metastasize. Current tools are imperfect for predicting who will have distant spread of disease. The utility of the modified Glasgow Prognostic Score (mGPS) calculated from C-reactive protein (CRP) and albumin levels, has been well-studied as a pre-operative predictive tool in patients with various solid organ malignancies, including clear cell renal cell carcinoma. This score has not been used in the post-operative setting, and we hypothesized that mGPS can be a powerful tool to predicting overall survival. Methods: Patients undergoing nephrectomy for clinically localized RCC from 2005 to 2010 were studied. Inclusion criteria required clear cell histology and no nodal or metastatic disease at the time of surgery. Additionally, only patients with post-operative C-reactive protein and albumin recorded were included in the analyses. Demographic and clinico-pathological variables were analyzed as categorical variables with the exception of age and tumor size, which were analyzed as continuous variables. Patients were assigned an mGPS score of 0, 1, or 2 based on post-operative data (0 = CRP ≤ 10 mg/l, 1 = CRP>10 mg/l and 2 = CRP>10 mg/l and albumin<3.5 g/dL). Survival analyses utilized Kaplan-Meier and multivariate Cox regression models. Results: Study criteria were met in 142 patients. Mean age was 59 years and 61% were men. No patients had T4 disease while 25% had T3, 9% had T2, and 66% had T1 disease. A post-operative mGPS of 0, 1, and 2 was assigned to 69%, 13% and 18% of the study population, respectively. Multivariate analysis identified post-operative high mGPS (mGPS = 2) as an independent predictor of overall survival (HR 5.591; CI 95% 1.508, 20.734; p = 0.010). Conclusions: In patients with clinically localized clear cell renal cell carcinoma, post-operative mGPS score is an independent predictor of overall survival. Accordingly, mGPS may be a useful tool to monitor disease progression in this patient population.

Significance of preoperative butyrylcholinesterase as an independent predictor of overall survival in patients with renal clear cell carcinoma treated with nephrectomy.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 458-458
Author(s):  
Takuya Koie ◽  
Hayato Yamamoto ◽  
Atsushi Imai ◽  
Shingo Hatakeyama ◽  
Takahiro Yoneyama ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Cell Carcinoma ◽  
Distant Metastasis ◽  
Renal Cell ◽  
Clear Cell ◽  
Independent Predictor ◽  
Protein Energy Malnutrition ◽  
Univariate Analysis

458 Background: Prognostic factors for overall survival (OS) of the patients with clear cell renal cell carcinoma (cRCC) treated with nephrectomy are still not defined well. Butyrylcholinesterase (BChE) is an α-glycoprotein found in the nervous system and liver. Advanced cancer is a condition with mild to moderate inflammation and interacts with various degree of protein-energy malnutrition. In this study, we analyzed the potential preoperative prognostic significance of BChE in patients with cRCC undergoing nephrectomy. Methods: etween 1992 and 2013, we treated 551 patients with renal cell carcinoma. Of these 400 patients with cRCC who underwent radical or partial nephrectomy were enrolled. Serum BChE was routinely measured before operation in all patients. Covariates included age, gender, performance status (PS), preoperative laboratory data, clinical T stage, and distant metastasis status. Univariate analyses were performed using the Kaplan-Meier and log-rank methods. Multivariate analysis was performed using a Cox proportional hazard model. Univariate and multivariate analyses were performed to determine clinical factors that associated with OS. Results: Of these, 302 patients had an organ-confined disease (T1-2N0M0) and 56 patients had a distant metastasis (any T, any N, and M1). The median BChE level was 250U/L (normal range from 168 to 470U/L). The median follow-up period was 34 months. At the time of analysis, 26 patients (6.5%) had alive with recurrent cRCC and 38 patients (9.5%) had died from cRCC. The 3-year OS rate for our entire cohort of 400 patients was 88%. The 3-year OS rates were 89.3% and 77.7% in the BChE ≥100 and <100U/L groups (p= 0.004). In the univariate analysis, PS, anemia, hypoalbuminemia, BChE, corrected calcium, C-reactive protein, and distant metastasis status were significantly associated with OS. Multivariate analysis revealed that BChE and distant metastasis status were significantly associated with OS. Conclusions: These data suggest a possible role of pre-operative BChE as an independent predictor of OS after nephrectomy for cRCC.

scholarly journals Preoperative Butyrylcholinesterase Level as an Independent Predictor of Overall Survival in Clear Cell Renal Cell Carcinoma Patients Treated with Nephrectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Takuya Koie ◽  
Chikara Ohyama ◽  
Jotaro Mikami ◽  
Hiromichi Iwamura ◽  
Naoki Fujita ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Distant Metastasis ◽  
Renal Cell ◽  
Clear Cell ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Cell Renal Cell Carcinoma

The prognostic factors for the overall survival (OS) of clear cell renal cell carcinoma (ccRCC) patients treated with nephrectomy are not well defined. In the present study, we investigated the prognostic significance of preoperative butyrylcholinesterase (BChE) levels in 400 ccRCC patients undergoing radical or partial nephrectomy from 1992 to 2013 at our institution. Univariate and multivariate analyses were performed to determine the clinical factors associated with OS. Among the enrolled patients, 302 were diagnosed with organ-confined disease only (T1-2N0M0), 16 with lymph node metastases, and 56 with distant metastases. The median preoperative BChE level was 250 U/L (normal range, 168–470 U/L), and median follow-up period was 36 months. The 3-year OS rate in patients with preoperative BChE levels of ≥100 U/L was significantly higher than in those with levels of <100 U/L (89.3% versus 77.7%,P=0.004). On univariate analysis, performance status; anemia; hypoalbuminemia; preoperative levels of BChE, corrected calcium, and C-reactive protein; and distant metastasis status were significantly associated with OS. Multivariate analysis revealed that preoperative BChE levels and distant metastasis status were significantly associated with OS. Our findings suggest a possible role of preoperative BChE levels as an independent predictor of OS after nephrectomy in ccRCC patients.

scholarly journals Nuclear and cytosolic pS727-STAT3 levels correlate with overall survival of patients affected by clear cell renal cell carcinoma (ccRCC)

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jazmine Arévalo ◽  
David Lorente ◽  
Enrique Trilla ◽  
María Teresa Salcedo ◽  
Juan Morote ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Cell Renal Cell Carcinoma ◽  
Independent Manner ◽  
Fuhrman Grade ◽  
Transcription 3 ◽  
Aggressive Subtype

AbstractClear cell renal cell carcinoma (ccRCC) is the most frequent and aggressive subtype of renal carcinoma. So far, the basis of its oncogenesis remains unclear resulting in a deficiency of usable and reliable biomarkers for its clinical management. Previously, we showed that nuclear expression of the signal transducer and activator of transcription 3 (STAT3), phosphorylated at its serine 727 (pS727), was inversely proportional to the overall survival of ccRCC patients. Therefore, in the present study, we validated the value of pS727-STAT3 as a clinically relevant biomarker in ccRCC. This work is a retrospective study on 82 ccRCC patients treated with nephrectomy and followed-up for 10 years. Immunohistochemical expression of pS727-STAT3 was analyzed on a tissue microarray and nuclear and cytosolic levels were correlated with clinical outcome of patients. Our results showed that pS727-STAT3 levels, whether in the nucleus (p = 0.002; 95% CI 1.004–1.026) or the cytosol (p = 0.040; 95% CI 1.003–1.042), significantly correlate with patients’ survival in an independent-manner of clinicopathological features (Fuhrman grade, risk group, and tumor size). Moreover, we report that patients with high pS727-STAT3 levels who undergone adjuvant therapy exhibited a significant stabilization of the disease (~ 20 months), indicating that pS727-STAT3 can pinpoint a subset of patients susceptible to respond well to treatment. In summary, we demonstrated that high pS727-STAT3 levels (regardless of their cellular location) correlate with low overall survival of ccRCC patients, and we suggested the use of pS727-STAT3 as a prognostic biomarker to select patients for adjuvant treatment to increase their survival.

scholarly journals Down-regulation of BCL2L13 renders poor prognosis in clear cell and papillary renal cell carcinoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Meng ◽  
Luojin Zhang ◽  
Mingjun Zhang ◽  
Kaiqin Ye ◽  
Wei Guo ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Kidney Cancer ◽  
Renal Cell ◽  
Poor Prognosis ◽  
Clear Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Functional Enrichment ◽  
Cancer Tissue ◽  
Down Regulation

Abstract Background BCL2L13 belongs to the BCL2 super family, with its protein product exhibits capacity of apoptosis-mediating in diversified cell lines. Previous studies have shown that BCL2L13 has functional consequence in several tumor types, including ALL and GBM, however, its function in kidney cancer remains as yet unclearly. Methods Multiple web-based portals were employed to analyze the effect of BCL2L13 in kidney cancer using the data from TCGA database. Functional enrichment analysis and hubs of BCL2L13 co-expressed genes in clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma (pRCC) were carried out on Cytoscape. Evaluation of BCL2L13 protein level was accomplished through immunohistochemistry on paraffin embedded renal cancer tissue sections. Western blotting and flow cytometry were implemented to further analyze the pro-apoptotic function of BCL2L13 in ccRCC cell line 786-0. Results BCL2L13 expression is significantly decreased in ccRCC and pRCC patients, however, mutations and copy number alterations are rarely observed. The poor prognosis of ccRCC that derived from down-regulated BCL2L13 is independent of patients’ gender or tumor grade. Furthermore, BCL2L13 only weakly correlates with the genes that mutated in kidney cancer or the genes that associated with inherited kidney cancer predisposing syndrome, while actively correlates with SLC25A4. As a downstream effector of BCL2L13 in its pro-apoptotic pathway, SLC25A4 is found as one of the hub genes that involved in the physiological function of BCL2L13 in kidney cancer tissues. Conclusions Down-regulation of BCL2L13 renders poor prognosis in ccRCC and pRCC. This disadvantageous factor is independent of any well-known kidney cancer related genes, so BCL2L13 can be used as an effective indicator for prognostic evaluation of renal cell carcinoma.

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