Followup of Neutrophil-to-Lymphocyte Ratio and Recurrence of Clear Cell Renal Cell Carcinoma

Ohno, Yoshio; Nakashima, Jun; Ohori, Makoto; Gondo, Tatsuo; Hatano, Tadashi; Tachibana, Masaaki

doi:10.1016/j.juro.2011.10.026

Cited by 119 publications

(94 citation statements)

References 24 publications

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“…However, in an AS-eligible cohort, in which the variability of PSA is limited, leukocyte subgroups and NLR analysis might potentially offer additional parameters that can further stratify a seemingly homogenous group of patients. Although studies have also shown that the postoperative NLR is a prognostic marker for recurrence and measure of response to therapy in renal cell carcinoma, 26,27 our analyses for this project were limited to the preoperative setting to assess the cancer-related inflammation manifested in the pretreatment hematologic parameters.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil and Lymphocyte Counts as Clinical Markers for Stratifying Low-Risk Prostate Cancer

Kwon

Han

et al. 2016

Clinical Genitourinary Cancer

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Appropriate patient selection for active surveillance is challenging. Our study of 217 patients demonstrated that the preoperative absolute neutrophil and lymphocyte counts were better predictors of aggressive oncologic features than were the neutrophil-to-lymphocyte ratio in the assessment of low-risk prostate cancer patients. Our findings suggest that routine hematologic workup could be used to further stratify low-risk prostate cancer patients. Introduction The neutrophil-to-lymphocyte ratio (NLR) has emerged as a ubiquitous prognostic biomarker in cancer-related inflammation, specifically in patients with metastatic castration-resistant prostate cancer (PCa). We evaluated the clinical utility of the preoperative NLR, absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) as a risk stratification tool for patients with low-risk PCa. Materials and Methods We identified 217 low-risk PCa patients with preoperative hematologic data who had met the criteria for active surveillance but had undergone robot-assisted radical prostatectomy at our institution from 2006 to 2015. Logistic regression models were constructed to determine whether the baseline NLR, ANC, and ALC were associated with upstaging, upgrading, and biochemical recurrence (BCR). Survival analyses were performed using the Kaplan-Meier method. Results On multivariate analysis, a higher prostate-specific antigen level (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.148–2.104), a greater number of positive cores (OR, 2.098; 95% CI, 1.043–2.104), and a higher ALC (OR, 4.311; 95% CI, 1.258–14.770) were associated with upstaging. More importantly, the 5-year biochemical recurrence-free survival was significantly lower in the high ANC group (ANC > 4.0 × 109/L) compared with that of the low ANC group (P = .011). The NLR was not associated with upstaging, upgrading, or BCR in our study cohort (P = .368, P = .573, and P = .504, respectively). The only significant association with upgrading was patient age (OR, 1.106; 95% CI, 1.043–1.173). Conclusion NLR was not useful in predicting adverse pathologic outcomes in our patients with low-risk PCa. However, relative neutrophilia and lymphocytosis might indicate an early manifestation of harboring a more aggressive PCa.

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Section: Discussionmentioning

confidence: 99%

Neutrophil and Lymphocyte Counts as Clinical Markers for Stratifying Low-Risk Prostate Cancer

Kwon

Han

et al. 2016

Clinical Genitourinary Cancer

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“…[20] Preoperative anemia (hemoglobin <13.5 g/dL in males and <12.0 g/dL in females) is established adverse prognostic factor, while recent studies confirm that pre- and post-treatment neutrophil to lymphocyte ratio is a significant prognostic factor for recurrence in patients with clear cell carcinoma. [2122]…”

Section: Discussionmentioning

confidence: 99%

Clinico-pathological prognostic factors of renal cell carcinoma: A 15-year review from a single center in Greece

et al. 2014

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Aim:To investigate the prognostic significance of certain clinical and pathological factors of renal cell cancer.Materials and Methods:One hundred and fourteen patients who underwent radical nephrectomy between 1996 and 2011 in our hospital were examined. Parameters including age, gender, mode of presentation, hematological and pathological parameters were evaluated for their role as predictors of disease-free and overall survival.Results:Median follow-up was 69 months. Predominant histological type, pathological stage, and nuclear grade were clear cell carcinoma, pT1, and Fuhrman II, respectively. Five-year overall and disease-free survival were 86% and 82%, respectively. Only nuclear grade (P = 0.02) and preoperative anemia (P < 0.01) were correlated with overall survival, while pathological stage, nuclear grade, anemia, and neutrophil-to-lymphocyte ratio of 2.7 or greater were associated with disease-free survival (P = 0.02, P = 0.038, P < 0.01, P = 0.049, respectively). In the multivariate setting, anemia (P = 0.04) and pathological stage (P = 0.026) were the only independent statistically significant predictors of disease-free survival, while anemia (P = 0.018) and neutrophil to lymphocyte ratio (P = 0.034) were the only factors correlated with overall survival.Conclusions:Due to the wide application of various imaging studies, patients with kidney cancer are diagnosed more often with localized disease and favorable pathological features. Fuhrman nuclear grade, pathological stage, preoperative anemia, and neutrophil to lymphocyte ratio are strongly associated with survival. In localized disease, such information could be used to guide the intensity of follow-up and identify high-risk patients who can be targeted for adjuvant therapy trials.

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“…[ 153,431] Localized renal cell carcinoma The presence of intratumoral neutrophils was associated with short recurrence-free survival. [390] Metastatic renal cell carcinoma Patients with elevated neutrophil count (>6,500 cells/μl) showed a shorter overall survival.…”

Section: Prognostic Values Of Neutrophils and Other Myeloid Subtypes mentioning

confidence: 99%

The Multifaceted Roles Neutrophils Play in the Tumor Microenvironment

Sionov

Fridlender

Granot

2014

Cancer Microenvironment

342

261

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Neutrophils are myeloid cells that constitute 50-70 % of all white blood cells in the human circulation. Traditionally, neutrophils are viewed as the first line of defense against infections and as a major component of the inflammatory process. In addition, accumulating evidence suggest that neutrophils may also play a key role in multiple aspects of cancer biology. The possible involvement of neutrophils in cancer prevention and promotion was already suggested more than half a century ago, however, despite being the major component of the immune system, their contribution has often been overshadowed by other immune components such as lymphocytes and macrophages. Neutrophils seem to have conflicting functions in cancer and can be classified into anti-tumor (N1) and pro-tumor (N2) sub-populations. The aim of this review is to discuss the varying nature of neutrophil function in the cancer microenvironment with a specific emphasis on the mechanisms that regulate neutrophil mobilization, recruitment and activation.

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Followup of Neutrophil-to-Lymphocyte Ratio and Recurrence of Clear Cell Renal Cell Carcinoma

Abstract: The posttreatment neutrophil-to-lymphocyte ratio change was a significant prognostic factor for recurrence as well as tumor size and pathological tumor stage in patients with clear cell renal cell carcinoma.

Cited by 119 publications

References 24 publications

Neutrophil and Lymphocyte Counts as Clinical Markers for Stratifying Low-Risk Prostate Cancer

Neutrophil and Lymphocyte Counts as Clinical Markers for Stratifying Low-Risk Prostate Cancer

Clinico-pathological prognostic factors of renal cell carcinoma: A 15-year review from a single center in Greece

The Multifaceted Roles Neutrophils Play in the Tumor Microenvironment

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