Pretreatment Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of Recurrence in Patients With Nonmetastatic Renal Cell Carcinoma
- 30 September 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 184 (3), 873-878
- https://doi.org/10.1016/j.juro.2010.05.028
Abstract
Purpose: We investigated the prognostic significance of the neutrophil-to-lymphocyte ratio to predict recurrence in patients with nonmetastatic renal cell carcinoma. Materials and Methods: We retrospectively reviewed the records of 192 patients with nonmetastatic renal cell carcinoma (T1-4N0M0) who underwent nephrectomy between 1986 and 2000. Mean followup was 93 months (range 6 to 232) months. We assessed the prognostic value of the pretreatment neutrophil-to-lymphocyte ratio, and other clinical and laboratory parameters on univariate and multivariate analysis. Results: Presentation mode, tumor stage, C-reactive protein, lymphocyte count and the neutrophil-to-lymphocyte ratio significantly correlated with recurrence-free survival on univariate analysis. The recurrence-free survival rate in patients with a neutrophil-to-lymphocyte ratio of less than 2.7 was 93.7% at 5 years and 79.8% at 10 years, significantly higher than the 77.9% and 58.4%, respectively, in patients with a ratio of 2.7 or greater (p = 0.0205). Multivariate analysis revealed that T stage and the neutrophil-to-lymphocyte ratio were independent predictors of recurrence. The 10-year survival rate in patients at low risk (T2 or less and neutrophil-to-lymphocyte ratio less than 2.7), intermediate risk (T2 or less and ratio 2.7 or greater, or T3 or greater and ratio less than 2.7) and high risk (T3 or greater and ratio 2.7 or greater) was 82.0%, 63.6% and 33.0%, respectively, which were significantly different. Conclusions: An increased pretreatment neutrophil-to-lymphocyte ratio is an independent predictor of recurrence. The combination of T stage and the neutrophil-to-lymphocyte ratio can be used to stratify recurrence risk in patients with nonmetastatic renal cell carcinoma.Keywords
This publication has 28 references indexed in Scilit:
- Cancer-related inflammationNature, 2008
- Correlates of circulating C-reactive protein and serum amyloid A concentrations in breast cancer survivorsBreast Cancer Research and Treatment, 2008
- The Baseline Ratio of Neutrophils to Lymphocytes Is Associated with Patient Prognosis in Advanced Gastric CancerOncology, 2007
- Increased preoperative serum C‐reactive protein level predicts a poor prognosis in patients with localized renal cell carcinomaBJU International, 2006
- Prognostic Factors in Renal Cell CarcinomaSeminars in Oncology, 2006
- Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancerJournal of Surgical Oncology, 2005
- C-REACTIVE PROTEIN: A BIOMARKER OF SURVIVAL IN PATIENTS WITH METASTATIC RENAL CELL CARCINOMA TREATED WITH SUBCUTANEOUS INTERLEUKIN-2 BASED IMMUNOTHERAPYJournal of Urology, 2005
- Cancer Statistics, 2004CA: A Cancer Journal for Clinicians, 2004
- Surveillance after radical or partial nephrectomy for localized renal cell carcinoma and management of recurrent diseaseUrologic Clinics of North America, 2003
- Systemic inflammatory response predicts survival following curative resection of colorectal cancerBritish Journal of Surgery, 2003