Elevated preoperative neutrophil-to-lymphocyte ratio may be associated with decreased overall survival in patients with metastatic clear cell renal cell carcinoma undergoing cytoreductive nephrectomy

doi:10.1016/j.ajur.2015.09.004

Asian Journal of Urology, 2016, 3 (1): 20-25 doi: 10.1016/j.ajur.2015.09.004

Original Article

Elevated preoperative neutrophil-to-lymphocyte ratio may be associated with decreased overall survival in patients with metastatic clear cell renal cell carcinoma undergoing cytoreductive nephrectomy

Yoram S. Baum, Dattatraya Patil, Jonathan H. Huang, Stephanie Spetka, Mersiha Torlak, Peter T. Nieh, Mehrdad Alemozaffar, Kenneth Ogan, Viraj A. Master

Department of Urology, Emory University School of Medicine, Atlanta, GA, USA

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Abstract Objective: Inflammatory serum markers have proven to be a powerful predictive tool of patient prognosis in cancer treatment for a wide variety of solid organ malignancies, predominantly in the context of localized disease. In this study we evaluated the preoperative neutrophil-to-lymphocyte ratio (NLR) as a predictive tool in patients with metastatic clear cell renal cell carcinoma (RCC).
Methods: Sixty-four patients with metastatic clear cell RCC undergoing nephrectomy were selected. Only patients with preoperative NLR were included for survival analysis. Patients were categorized into high and low NLR score determined by plotting the NLR ROC curve. Multivariable analysis was performed.
Results: Median age was 60.8 years (38.2-81.2). Median follow-up time was 8.1 months (0.1-106.3). Fuhrman grade distribution was: 2 (3.1%) grade 1, 6 (9.4%) grade 2, 24 (37.5%) grade 3 and 32 (50.0%) grade 4. Median NLR score was 3.5 (1.4-31.0). NLR≥4 was associated with decreased overall survival compared toNLR < 4 (p=0.017).Multivariable survival analysis showed NLR≥4 as an independent predictor of survival (Hazard ratio (HR) 2.41, 95%CI 1.05-5.50, p=0.03).
Conclusion: Elevated preoperative NLR is associatedwith poor prognosis in patients withmetastatic kidney cancer. Preoperative NLR is a useful tool, which can predict prognosis, stratify patients for postoperative surveillance, and help guide decisions for therapy.

Key words： Renal cancer Neutrophil-tolymphocyte ratio Cytoreductive nephrectomy Prognosis

Received: 06 June 2015 Published: 29 January 2016

Corresponding Authors: Viraj A. Master E-mail: vmaster@emory.edu

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	Yoram S. Baum
	Dattatraya Patil
	Jonathan H. Huang
	Stephanie Spetka
	Mersiha Torlak
	Peter T. Nieh
	Mehrdad Alemozaffar
	Kenneth Ogan
	Viraj A. Master

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Yoram S. Baum,Dattatraya Patil,Jonathan H. Huang, et al. Elevated preoperative neutrophil-to-lymphocyte ratio may be associated with decreased overall survival in patients with metastatic clear cell renal cell carcinoma undergoing cytoreductive nephrectomy[J]. Asian Journal of Urology, 2016, 3(1): 20-25.

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http://www.ajurology.com/EN/10.1016/j.ajur.2015.09.004 OR http://www.ajurology.com/EN/Y2016/V3/I1/20

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