TY - JOUR
T1 - Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Nonmetastatic Renal Cell Carcinoma
T2 - A Large, Multicenter Cohort Analysis
AU - Byun, Seok Soo
AU - Hwang, Eu Chang
AU - Kang, Seok Ho
AU - Hong, Sung Hoo
AU - Chung, Jinsoo
AU - Kwon, Tae Gyun
AU - Kim, Hyeon Hoe
AU - Kwak, Cheol
AU - Kim, Yong June
AU - Lee, Won Ki
N1 - Publisher Copyright:
© 2016 Seok-Soo Byun et al.
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84998727420&partnerID=8YFLogxK
U2 - 10.1155/2016/5634148
DO - 10.1155/2016/5634148
M3 - Article
C2 - 27891517
AN - SCOPUS:84998727420
SN - 2314-6133
VL - 2016
JO - BioMed Research International
JF - BioMed Research International
M1 - 5634148
ER -
