The impact of complete blood count-derived inflammatory markers on survival in patients with localized renal cell cancer treated with partial or radical nephrectomy – a single center retrospective study

Abstract BackroundSeveral hematological markers of systemic inflammation were reported as prognostic in renal cell carcinoma (RCC). We aimed to re-evaluate the prognostic significance of clinicopathologic features and compare the predictive value of different inflammatory markers in RCC.MethodsFour hundred ninety-five patients treated with nephrectomy for primary localized or locally advanced RCC were included in the retrospective analysis. The median follow-up was 48 months.ResultsPatients with higher neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), neutrophil/erythrocyte ratio (NER), derived neutrophil/lymphocyte ratio (dNLR), and lower lymphocyte/monocyte ratio (LMR) and hemoglobin/platelet ratio (HPR) had worse cancer-specific survival (CSS). In the multivariate analysis tumour stage, grade, age and high SIRI constituted independent factors predicting CSS. The model including SIRI values achieved C-index 0.903. Alternative multivariate models that included SII and NLR were characterized by comparable C-indexes i.e. 0.902 and 0.890, respectively. Different inflammatory markers could not be utilized in a single model, as they show a strong correlation with one other (SII, SIRI and NLR), and seem to provide similar prognostic information. Tumour grade and diameter were independent predictors for recurrence-free survival, whereas age, tumour grade and high NER (or high SIRI/ SII in alternative models) were prognostic for overall survival.ConclusionsMarkers of systemic inflammation might provide additional prognostic information (especially SIRI, SII, NLR and NER) and further increase the predictive accuracy of already available models in localized and locally advanced renal cell carcinoma. Clinicopathological features (stage, grade and age) remain the most important prognostic factors for oncological outcomes in RCC patients treated with nephrectomy. For the first time, we show the prognostic value of neutrophil-to-erythrocyte ratio, which constitutes an independent risk factor of overall survival.Trial registrationnot applicable

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The role of neutrophil-lymphocyte ratio as a prognostic indicator in patients undergoing nephrectomy for renal cell carcinoma

Canadian Urological Association Journal ◽

10.5489/cuaj.4872 ◽

2018 ◽

Vol 12 (7) ◽

pp. E348-8 ◽

Cited By ~ 5

Author(s):

Nathan Grimes ◽

Cathal Hannan ◽

Matthew Tyson ◽

Ali Thwaini

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Cell Carcinoma ◽

Renal Cell ◽

Primary Tumour ◽

Preoperative Staging ◽

Recurrence Free Survival ◽

Free Survival ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Introduction: Prognosis in patients with cancer is influenced by underlying tumour biology and also the host inflammatory response to the disease. There is limited evidence to suggest that an elevated neutrophil-lymphocyte ratio (NLR) predicts a poorer prognosis in patients undergoing nephrectomy for renal cell carcinoma (RCC). The aim of this paper is to investigate if patients undergoing nephrectomy for RCC with NLR ≤4 have a better overall and recurrence-free survival than patients with NLR >4.Methods: All patients who underwent nephrectomy at a single centre between January 1, 2011 and December 31, 2014 were identified. Patients were included if postoperative histology demonstrated RCC and if preoperative NLR was available. Patients were excluded if nephrectomy was not curative intent (i.e., cytoreductive nephrectomy), if primary tumour was graded to be T3b‒4 disease, if there was presence of nodal or metastatic disease on preoperative staging, or if adequate followup notes were not available. Primary and secondary outcomes were overall survival and recurrence-free survival, respectively.Results: A total of 154 patients were included in analysis of overall survival; 146 patients were included in analysis of recurrence-free survival. Patients with NLR ≤4 had a much better overall survival than patients with NLR >4 (95% vs. 78%; p=0.0219). Patients with NLR >4 also had higher rates of recurrence (p=0.0218).Conclusions: NLR may be a useful tool in identifying patients who may benefit from more frequent surveillance in the early postoperative period and may allow clinicians to offer surveillance schemes tailored to the individual patient.

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Neutrophil–lymphocyte ratio as a prognostic factor for survival in patients with advanced renal cell carcinoma (Turkish Oncology Group Study)

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155219900908 ◽

2020 ◽

Vol 26 (7) ◽

pp. 1583-1589

Author(s):

Mutlu Hizal ◽

Mehmet AN Sendur ◽

Hatime Arzu Yasar ◽

Kadriye Bir Yucel ◽

Cagatay Arslan ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Cell Carcinoma ◽

Renal Cell ◽

Kinase Inhibitors ◽

Advanced Renal Cell Carcinoma ◽

Study Group ◽

Poor Overall Survival ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Background To describe the prognostic value of neutrophil–lymphocyte ratio and its effect on survival in in patients with advanced renal cell carcinoma. Methods We retrospectively analyzed 331 patients. The cut-off value of neutrophil–lymphocyte ratio was specified as “3” which is mostly close—and also clinically easily applicable—to the median neutrophil–lymphocyte ratio level of our study group. High group is identified as neutrophil–lymphocyte ratio >3 (n = 160) and low group is identified as neutrophil–lymphocyte ratio ≤3 (n = 163). Results A total of 331 (with 211 male and 120 female) patients were enrolled to study. The median age of the patients was 58. The International Metastatic RCC Database Consortium risk score is calculated for the 72.8% (n = 241) of the study group and among these patients, favorable, intermediate, and poor risk rates were 22, 45.2, and 32.8%. The total usage of tyrosine kinase inhibitors reached 78% of the patients. The median overall survival was 32 months versus 11 months in the neutrophil–lymphocyte ratio low and high groups, respectively (HR: 0.49 (95% CI 0.37–0.65), p < 0.001). Conclusion In conclusion, the pre-treatment value of elevated neutrophil–lymphocyte ratio might be a predictor of poor overall survival in advanced renal cell carcinoma patients.

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