Clinical significance of prognostic nutritional index (PNI)-monocyte-to-lymphocyte ratio (MLR)-platelet (PLT) score on postoperative outcomes in non-metastatic clear cell renal cell carcinoma

Ren, Wei; Zeng, Hao; Li, Cheng; Zhang, Ying Jun; Yang, Chen; Nie, Linru; Yang, Congcong; Yao, Peng; Han, Jianda; Dong, Zhen

doi:10.1186/s12893-023-02001-x

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…The adverse prognosis underscored the importance of individualized treatment; whereas only pathological tumor stage, tumor grade and lymph node metastasis were de nitely identi ed as the risk factors in European Association of Urology (EAU) guidelines [2]. Recently, several combinations of hematological markers re ecting nutritional and/or systemic in ammatory status have been widely studied, including the neutrophil-to-lymphocyte ratio (NLR), and proven to be related to the poor prognosis in various malignancies [5][6][7][8]. Of note, most previous studies have just revealed the potential relationship between the markers mentioned above and survival outcomes; whereas limited data exist with regard to the prognostic value of incorporating these markers into the basal prediction models which precisely acts as a concern of clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The Lymphovascular Invasion and Neutrophil-to-lymphocyte Ratio Increase the Prognostic Value of the Basal Model in UTUC Patients after Radical Nephroureterectomy

Wang

Chen

et al. 2023

Preprint

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Objective To determine the prognostic value of lymphovascular invasion (LVI), neutrophil-to-lymphocyte ratio (NLR) and their combination for predicting oncological outcomes in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU). Materials and methods Data from 581 UTUC patients who underwent RNU at our institution from May 2003 to June 2019 were retrospectively analyzed. The predictive value on the endpoints of interest, including overall survival (OS), cancer-specific survival (CSS) and metastasis-free survival (MFS), was assessed by Kaplan‒Meier curves and the Cox proportional hazard model. The receiver operating characteristic (ROC) curve was computed to evaluate the predictive ability. Results Patients in the LVI-positive group or NLR-high group had a significantly worse OS, CSS and MFS than those in the LVI-negative group or NLR-low group. LVI-positive and NLR-high coexistence was an independent risk factor for OS, CSS and MFS in multivariate analyses (HR 2.28, 95% CI 1.52–3.44; HR 2.56, 95% CI 1.63–4.01; HR 1.83, 95% CI 1.09–3.06, respectively). Furthermore, adding LVI and NLR to the basal model, consisting of tumor stage, grade and lymph node metastasis, improved the ability to predict the survival outcomes of UTUC patients in ROC analysis. Conclusion LVI, NLR and their combination were all independent risk factors for OS, CSS and MFS in UTUC patients after RNU. Adding LVI and NLR into the basal model enhanced the prognostic prediction ability throughout the follow-up period. It might be a feasible and promising tool for risk stratification and individualized treatment.

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Section: Introductionmentioning

confidence: 99%

The Lymphovascular Invasion and Neutrophil-to-lymphocyte Ratio Increase the Prognostic Value of the Basal Model in UTUC Patients after Radical Nephroureterectomy

Wang

Chen

et al. 2023

Preprint

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Predicting the prognosis of operable gastric cancer patients by dynamic changes in platelets before and after surgery: a retrospective cohort study

Li,

Yang,

Wang

et al. 2023

J Cancer Res Clin Oncol

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Predicting the prognosis of patients with renal cell carcinoma based on the systemic immune inflammation index and prognostic nutritional index

Ma,

Liu,

Dong

et al. 2024

Sci Rep

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The aim of the study was to analyze and discuss the value of preoperative systemic immune inflammation index (SII) and prognostic nutritional index (PNI) in predicting the prognosis of patients with renal cell carcinoma (RCC) after operation, and to establish a nomogram prediction model for patients with RCC after operation based on SII and PNI. From January 2014 to December 2018, 210 patients with RCC who underwent surgical treatment at the Xuzhou Central Hospital were selected as the research object. The receiver operating characteristic curve (ROC) was used to determine the optimal cut-off value for preoperative SII, PNI, LMR, PLR, NLR and the patients were divided into groups according to the optimal cutoff values. The survival rate of patients was evaluated. The risk factors that affect the prognosis of patients with RCC were determined by LASSO and Cox regression analysis, and a prognostic nomogram was constructed based on this result. The bootstrap method was used for internal verification of the nomogram model. The prediction efficiency and discrimination of the nomogram model were evaluated by the calibration curve and index of concordance (C-index), respectively. The average overall survival (OS) of all patients was 75.385 months, and the 1-, 2-and 3-year survival rates were 95.5%, 86.6% and 77.2%, respectively. The survival curve showed that the 5-year OS rate of low SII group was significantly higher than that of high SII group (89.0% vs. 64.5%; P < 0.05), and low PNI group was significantly lower than those in high PNI group (43.4% vs. 87.9%; p < 0.05). There were significant differences between preoperative SII and CRP, NLR, PLR, LMR, postoperative recurrence, pathological type and AJCC stage (P < 0.05). There were significant differences between preoperative PNI and BMI, platelet, NLR, PLR, LMR, postoperative recurrence, surgical mode and Fuhrman grade (P < 0.05). The ROC curve analysis showed that the AUC of PNI (AUC = 0.736) was higher than that of other inflammatory indicators, followed by the AUC of SII (0.718), and the difference in AUC area between groups was statistically significant (P < 0.05). The results from multivariate Cox regression analysis showed that SII, PNI, tumor size, tumor necrosis, surgical mode, pathological type, CRP, AJCC stage and Fuhrman grade were independent risk factors for postoperative death of patients with RCC. According to the results of Cox regression analysis, a prediction model for the prognosis of RCC patients was established, and the C-index (0.918) showed that the model had good calibration and discrimination. The subject’s operating characteristic curve indicates that the nomogram has good prediction efficiency (the AUC = 0.953). Preoperative SII and PNI, tumor size, tumor necrosis, surgical mode, pathological type, CRP, AJCC stage and Fuhrman grade are closely related to the postoperative prognosis of patients with renal cell carcinoma. The nomogram model based on SII, PNI, tumor size, tumor necrosis, surgical mode, pathological type, CRP, AJCC stage and Fuhrman grade has good accuracy, discrimination and clinical prediction efficiency.

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Clinical significance of prognostic nutritional index (PNI)-monocyte-to-lymphocyte ratio (MLR)-platelet (PLT) score on postoperative outcomes in non-metastatic clear cell renal cell carcinoma

Cited by 3 publications

References 28 publications

The Lymphovascular Invasion and Neutrophil-to-lymphocyte Ratio Increase the Prognostic Value of the Basal Model in UTUC Patients after Radical Nephroureterectomy

The Lymphovascular Invasion and Neutrophil-to-lymphocyte Ratio Increase the Prognostic Value of the Basal Model in UTUC Patients after Radical Nephroureterectomy

Predicting the prognosis of operable gastric cancer patients by dynamic changes in platelets before and after surgery: a retrospective cohort study

Predicting the prognosis of patients with renal cell carcinoma based on the systemic immune inflammation index and prognostic nutritional index

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