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Asian Journal of Urology, 2016, 3(1): 20-25    doi: 10.1016/j.ajur.2015.09.004
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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
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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摘要 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.
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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
关键词:  Renal cancer  Neutrophil-tolymphocyte ratio  Cytoreductive nephrectomy  Prognosis    
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
收稿日期:  2015-06-06      修回日期:  2015-08-25           出版日期:  2016-01-01      发布日期:  2016-01-29      整期出版日期:  2016-01-01
通讯作者:  Viraj A. Master    E-mail:  vmaster@emory.edu
引用本文:    
Yoram S. Baum, Dattatraya Patil, Jonathan H. Huang, Stephanie Spetka, Mersiha Torlak, Peter T. Nieh, Mehrdad Alemozaffar, Kenneth Ogan, Viraj A. Master. 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.
Yoram S. Baum, Dattatraya Patil, Jonathan H. Huang, Stephanie Spetka, Mersiha Torlak, Peter T. Nieh, Mehrdad Alemozaffar, Kenneth Ogan, Viraj A. Master. 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. Asian Journal of Urology, 2016, 3(1): 20-25.
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http://www.ajurology.com/CN/10.1016/j.ajur.2015.09.004  或          http://www.ajurology.com/CN/Y2016/V3/I1/20
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