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.

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 ◽  
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

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 Nomograms-based prediction of overall and cancer-specific survivals for patients with chromophobe renal cell carcinoma

2020 ◽  
pp. 153537022097710
Author(s):  
Chunyang Chen ◽  
Xinyu Geng ◽  
Rui Liang ◽  
Dongze Zhang ◽  
Meiyun Sun ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Operating Characteristic ◽  
Tumor Grade ◽  
Curve Analysis ◽  
Cancer Specific Survival ◽  
Decision Curve Analysis

This study built and tested two effective nomograms for the purpose of predicting cancer-specific survival and overall survival of chromophobe renal cell carcinoma (chRCC) patients. Multivariate Cox regression analysis was employed to filter independent prognostic factors predictive of cancer-specific survival and overall survival, and the nomograms were built based on a training set incorporating 2901 chRCC patients in a retrospective study (from 2004 to 2015) downloaded from the surveillance, epidemiology, and end results (SEER) database. The nomograms were verified on a validation cohort of 1934 patients, subsequently the performances of the nomograms were examined according to the receiver operating characteristic curve, calibration curves, the concordance (C-index), and decision curve analysis. The results showed that tumor grade, AJCC and N stages, race, marital status, age, histories of chemotherapy, radiotherapy and surgery were the individual prognostic factors for overall survival, and that AJCC, N and SEER stages, histories of surgery, radiotherapy and chemotherapy, age, tumor grade were individual prognostic factors for cancer-specific survival. According to C-indexes, receiver operating characteristic curves, and decision curve analysis outcomes, the nomograms showed a higher accuracy in predicting overall survival and OSS when compared with TNM stage and SEER stage. All the calibration curves were significantly consistent between predictive and validation sets. In this study, the nomograms, which were validated to be highly accurate and applicable, were built to facilitate individualized predictions of the cancer-specific survival and overall survival to patients diagnosed with chRCC between 2004 and 2015.

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.

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.

scholarly journals A novel prognostic cancer-related lncRNA signature in papillary renal cell carcinoma

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Binghai Chen ◽  
Di Dong ◽  
Qin Yao ◽  
Yuanzhang Zou ◽  
Wei Hu
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
High Efficiency ◽  
Risk Model ◽  
Cox Regression ◽  
Papillary Renal Cell Carcinoma ◽  
Clinical Feature ◽  
Roc Curve Analysis ◽  
Significant Difference

Abstract Background Papillary renal cell carcinoma (pRCC) ranks second in renal cell carcinoma and the prognosis of pRCC remains poor. Here, we aimed to screen and identify a novel prognostic cancer-related lncRNA signature in pRCC. Methods The RNA-seq profile and clinical feature of pRCC cases were downloaded from TCGA database. Significant cancer-related lncRNAs were obtained from the Immlnc database. Differentially expressed cancer-related lncRNAs (DECRLs) in pRCC were screened for further analysis. Cox regression report was implemented to identify prognostic cancer-related lncRNAs and establish a prognostic risk model, and ROC curve analysis was used to evaluate its precision. The correlation between RP11-63A11.1 and clinical characteristics was further analyzed. Finally, the expression level and role of RP11-63A11.1 were studied in vitro. Results A total of 367 DECRLs were finally screened and 26 prognostic cancer-related lncRNAs were identified. Among them, ten lncRNAs (RP11-573D15.8, LINC01317, RNF144A-AS1, TFAP2A-AS1, LINC00702, GAS6-AS1, RP11-400K9.4, LUCAT1, RP11-63A11.1, and RP11-156L14.1) were independently associated with prognosis of pRCC. These ten lncRNAs were incorporated into a prognostic risk model. In accordance with the median value of the riskscore, pRCC cases were separated into high and low risk groups. Survival analysis indicated that there was a significant difference on overall survival (OS) rate between the two groups. The area under curve (AUC) in different years indicated that the model was of high efficiency in prognosis prediction. RP11-63A11.1 was mainly expressed in renal tissues and it correlated with the tumor stage, T, M, N classifications, OS, PFS, and DSS of pRCC patients. Consistent with the expression in pRCC tissue samples, RP11-63A11.1 was also down-regulated in pRCC cells. More importantly, up-regulation of RP11-63A11.1 attenuated cell survival and induced apoptosis. Conclusions Ten cancer-related lncRNAs were incorporated into a powerful model for prognosis evaluation. RP11-63A11.1 functioned as a cancer suppressor in pRCC and it might be a potential therapeutic target for treating pRCC.

scholarly journals A Genomic-Clinicopathologic Nomogram Predicts Survival for Patients with Laryngeal Squamous Cell Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Jie Cui ◽  
Qingquan Wen ◽  
Xiaojun Tan ◽  
Zhen Chen ◽  
Genglong Liu
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Calibration Curve ◽  
Survival Probability ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Cox Regression ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Decision Curve Analysis

Background. Long noncoding RNAs (lncRNAs), which have little or no ability to encode proteins, have attracted special attention due to their potential role in cancer disease. We aimed to establish a lncRNA signature and a nomogram incorporating the genomic and clinicopathologic factors to improve the accuracy of survival prediction for laryngeal squamous cell carcinoma (LSCC). Methods. A LSCC RNA-sequencing (RNA-seq) dataset and the matched clinicopathologic information were downloaded from The Cancer Genome Atlas (TCGA). Using univariable Cox regression and least absolute shrinkage and selection operator (LASSO) analysis, we developed a thirteen-lncRNA signature related to prognosis. On the basis of multivariable Cox regression analysis results, a nomogram integrating the genomic and clinicopathologic predictors was built. The predictive accuracy and discriminative ability of the inclusive nomogram were confirmed by calibration curve and a concordance index (C-index), and compared with the TNM staging system by C-index and receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was conducted to evaluate the clinical value of our nomogram. Results. Thirteen overall survival- (OS-) related lncRNAs were identified, and the signature consisting of the selected thirteen lncRNAs could effectively divide patients into high-risk and low-risk subgroups, with area under curves (AUC) of 0.89 (3-year OS) and 0.885 (5-year OS). Independent factors derived from multivariable analysis to predict survival were margin status, tumor status, and lncRNA signature, which were all assembled into the nomogram. The calibration curve for the survival probability showed that the predictions based on the nomogram coincided well with actual observations. The C-index of the nomogram was 0.82 (0.77-0.87), and the area under curve (AUC) of the nomogram in predicting overall survival (OS) was 0.938, both of which were significantly higher than the traditional TNM stage. Decision curve analysis further demonstrated that our nomogram had larger net benefit than TNM stage. Conclusion. An inclusive nomogram for patients with LSCC, comprising genomic and clinicopathologic variables, generates more accurate estimations of the survival probability when compared with TNM stage alone, but more data are needed before the nomogram is used in clinical practice.

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