scholarly journals Preoperative Neutrophil to Lymphocyte Ratio as a Prognostic Factor in Patients with Non-metastatic Renal Cell Carcinoma

2015 ◽  
Vol 16 (9) ◽  
pp. 3703-3708 ◽  
Author(s):  
Ru-Min Wen ◽  
Yi-Jing Zhang ◽  
Sha Ma ◽  
Ying-Li Xu ◽  
Yan-Su Chen ◽  
...  
2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 404-404 ◽  
Author(s):  
Nimira S. Alimohamed ◽  
Arnoud J. Templeton ◽  
Jennifer J. Knox ◽  
Xun Lin ◽  
Ronit Simantov ◽  
...  

404 Background: The neutrophil to lymphocyte ratio (NLR) is a marker of inflammation. We evaluated whether NLR is independently prognostic when adjusted for the International mRCC Database Consortium (IMDC) model and evaluated change in NLR ("NLR conversion") as a predictive marker of response to targeted therapy. Methods: A total of 5,227 metastatic renal cell carcinoma (mRCC) patients treated with targeted therapy were included; 1,199 patients in the training cohort from the IMDC and 4028 patients as the validation cohort from pooled prospective randomized controlled trials involving targeted therapy. NLR was examined at initiation of first-line targeted therapy and at 6 weeks after. The prognostic role of NLR and NLR conversion on overall survival (OS) and progression free survival (PFS) was assessed using Cox regression models adjusting for IMDC prognostic score. Results: Median baseline NLR was 3.4 and 2.9 in the training and validation cohorts, respectively. NLR >3.0 at baseline was independently associated with OS and PFS in both the training and validation cohorts (Table). A decrease in NLR by week 6 was associated with longer OS (21.1 vs. 9.7 months; HR 0.57, p<0.001), PFS (8.8 vs. 4.6 months; HR 0.54, p<0.001), and higher objective response rates (35% vs. 13%, p<0.001) compared to patients without a decrease. A rise in NLR showed opposite effects for all three endpoints. These findings were also confirmed in the validation set. Conclusions: NLR is an independent prognostic factor after controlling for IMDC criteria. NLR conversion can be an early biomarker of benefit to targeted therapy. [Table: see text]


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Seok-Soo Byun ◽  
Eu Chang Hwang ◽  
Seok Ho Kang ◽  
Sung-Hoo Hong ◽  
Jinsoo Chung ◽  
...  

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.


2013 ◽  
Vol 12 (4) ◽  
pp. e1376, S268a-e1376, S268b
Author(s):  
N. Grivas ◽  
V. Kafarakis ◽  
I. Tsimaris ◽  
S. Aspiotis ◽  
A. Stratis ◽  
...  

2017 ◽  
Vol 11 (5) ◽  
pp. 207 ◽  
Author(s):  
Jun Teishima ◽  
Shinya Ohara ◽  
Kousuke Sadahide ◽  
Shinsuke Fujii ◽  
Hiroyuki Kitano ◽  
...  

Introduction: The aim of our present study was to investigate the impact of the pretreatment neutrophil-to-lymphocyte ratio (NLR) on the antitumour effects of targeted agents in patients with metastatic renal cell carcinoma (mRCC).Methods: The NLRs in 283 cases of molecular targeted therapy for mRCC were measured before starting the prescription of the molecular targeted agent. The significance of pretreatment NLR on the site of metastatic organs and on progression-free survival (PFS)in each case was analyzed.Results: Metastases other than lung, which is defined as “extrapulmonary metastasis,” were observed in 190 cases (67.1%). The median of pretreated NLR was 2.39 (0.49‒68.7). In 97 of the 283 cases,pretreated NLR was 3.0 or higher. These cases were categorized as the high NLR group and the rest as the low NLR group. When the cases with extrapulmonary metastasis were investigated and classifiedbased on their pretreated NLR, 50% PFS in the high NLR and low NLR groups was 6.7 months and 12 months (p=0.0001), respectively. Multivariate analysis revealed that high NLR (>3.0) was an independent predictive factor for PFS in the cases with extrapulmonary metastasis (hazard ratio 2.762; p<0.0001), while there was no significant difference between PFS in the high and low NLR groups in cases with no extrapulmonary metastasis (p=0.3457).Conclusions: Our data indicate that the predictive significance of the NLR in mRCC cases involving targeted therapy depends on the metastatic organs. NLR is an independent predictive factor of PFS in cases of mRCC with extrapulmonary metastasis treated with targeted therapy.


Sign in / Sign up

Export Citation Format

Share Document