The platelet-to-lymphocyte ratio as a significant prognostic factor to predict survival outcomes in patients with synchronous metastatic renal cell carcinoma

Yuk, Hyeong Dong; Kang, Minyong; Hwang, Eu Chang; Park, Jae Young; Jeong, Chang Wook; Song, Cheryn; Seo, Seong Il; Byun, Seok Soo; Kwak, Cheol; Hong, Sung Hoo; Chung, Jinsoo; Lee, Hakmin

doi:10.4111/icu.20200002

Cited by 9 publications

(5 citation statements)

References 28 publications

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“…Additionally, a recent meta-analysis associated a high pretreatment neutrophil-to-lymphocyte ratio and PLR with progression and mortality in mRCC patients treated with immune checkpoint inhibitors. Collectively, these studies implicate multiple hematological parameters in RCC prognosis (44)(45)(46)(47).…”

Section: Discussionmentioning

confidence: 80%

“…In the report by De Giorgi et al., the systemic immune inflammation index and body mass index independently predicted OS in RCC patients treated with nivolumab ( 44 ). In studies of mRCC, a low pretreatment prognostic nutritional index was a potential risk factor after first-line therapy with tyrosine kinase inhibitors ( 45 ), and the PLR was an independent indicator of survival in a large cohort (n = 921) ( 46 ). Additionally, a recent meta-analysis associated a high pretreatment neutrophil-to-lymphocyte ratio and PLR with progression and mortality in mRCC patients treated with immune checkpoint inhibitors.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic significance of albumin-to-globulin ratio in patients with renal cell carcinoma: a meta-analysis

Mao

Yang

2023

Front. Oncol.

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BackgroundWhether the albumin-to-globulin ratio (AGR) predicts the prognosis of renal cell carcinoma (RCC) remains controversial. Herein, we performed a meta-analysis to critically evaluate the relationship between the AGR and RCC prognosis, as well as the association between the AGR and the clinicopathological characteristics of RCC.MethodsThe PubMed, Web of Science, Embase, and Cochrane Library databases were thoroughly and comprehensively searched from their inception until 24 June 2023. To determine the predictive significance of the AGR, hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated from the pooled data. The relationship between the AGR and the clinicopathological features of RCC was evaluated by estimating odds ratios (ORs) and 95% CIs in subgroup analyses.ResultsThe meta-analysis included nine articles involving 5,671 RCC cases. A low AGR significantly correlated with worse overall survival (OS) (HR = 1.82, 95% CI = 1.37–2.41, p <0.001) and progression-free survival (PFS) (HR = 2.44, 95% CI = 1.61–3.70, p <0.001). Analysis of the pooled data also revealed significant associations between a low AGR and the following: female sex (OR = 1.48, 95% CI = 1.31–1.67, p <0.001), pT stage T3–T4 (OR = 4.12, 95% CI = 2.93–5.79, p <0.001), pN stage N1 (OR = 3.99, 95% CI = 2.40–6.64, p <0.001), tumor necrosis (OR = 3.83, 95% CI = 2.23–6.59, p <0.001), and Fuhrman grade 3–4 (OR = 1.82, 95% CI = 1.34–2.42, p <0.001). The AGR was not related to histology (OR = 0.83, 95% CI = 0.60–1.15, p = 0.267).ConclusionIn patients with RCC, a low AGR strongly predicted poor OS and PFS and significantly correlated with clinicopathological features indicative of disease progression.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Prognostic significance of albumin-to-globulin ratio in patients with renal cell carcinoma: a meta-analysis

Mao

Yang

2023

Front. Oncol.

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“…The advantages of both diagnostic and prognostic models established here lie in the integrative analyses of multiple parameters rather than in individual ones, as reported in previous studies (8,38). This type of integrative analysis simultaneously covers multiple parameters related to diverse aspects of the disease and host, which might contribute to its effectiveness and performance.…”

Section: Discussionmentioning

confidence: 90%

Identification of diagnostic and prognostic signatures derived from preoperative blood parameters for oral squamous cell carcinoma

Wu¹,

Yao²,

Dai³

et al. 2021

Ann Transl Med

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Background: We aimed to develop novel diagnostic and prognostic signatures based on preoperative inflammatory, immunological, and nutritional parameters in blood (PIINPBs) by machine learning algorithms for patients with oral squamous cell carcinoma (OSCC). Methods: A total of 486 OSCC patients and 200 age and gender-matched non-OSCC patients who were diagnosed and treated at our institution for noninfectious, nontumor diseases were retrospectively enrolled and divided into training and validation cohorts. Based on PIINPB, 6 machine learning classifiers including random forest, support vector machine, extreme gradient boosting, naive Bayes, neural network, and logistic regression were used to derive diagnostic models, while least absolute shrinkage and selection operator (LASSO) analyses were employed to construct prognostic signatures. A novel prognostic nomogram integrating a PIINPB-derived prognostic signature and selected clinicopathological parameters was further developed. Performances of these signatures were assessed by receiver operating characteristic (ROC) curves, calibrating curves, and decision tree. Results: Diagnostic models developed by machine learning algorithms from 13 PIINPBs, which included counts of white blood cells (WBC), neutrophils (N), monocytes (M), lymphocytes (L), platelets (P), albumin (ALB), and hemoglobin (Hb), along with albumin-globulin ratio (A/G), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII), and prognostic nutritional index (PNI), displayed satisfactory discriminating capabilities in patients with or without OSCC, and among OSCC patients with diverse pathological grades and clinical stages. A prognostic signature based on 6 survival-associated PIINPBs (L, P, PNI, LMR, SII, A/G) served as an independent factor to predict patient survival. Moreover, a novel nomogram integrating prognostic signature and tumor size, pathological grade, cervical node metastasis, and clinical stage significantly enhanced prognostic power [3-year area under the curve (AUC) =0.825; 5-year AUC =0.845]. Conclusions: Our results generated novel and robust diagnostic and prognostic signatures derived from PIINPBs by machine learning for OSCC. Performance of these signatures suggest the potential for PIINPBs to supplement current regimens and provide better patient stratification and prognostic prediction.

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“…A study of patients with synchronous metastatic RCC by Yuk et al. reported an association between elevated PLR and poorer OS (HR=1.345; p<0.001) and CSS (HR=1.318, p<0.001) ( 30 ). Our study differs from the aforementioned work in that we included patients with localized disease and only patients who underwent extirpative surgery with partial or radical nephrectomy.…”

Section: Discussionmentioning

confidence: 99%

Association of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and De Ritis ratio with mortality in renal cell carcinoma: A multicenter analysis

et al. 2022

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BackgroundSeveral markers of inflammation have been associated with oncologic outcomes. Prognostic markers are not well-defined for renal cell carcinoma (RCC). We sought to investigate the association of preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and De Ritis ratio with mortality in RCC.MethodsMulti-center retrospective analysis of patients undergoing surgery for RCC. Primary outcome of interest was all-cause mortality (ACM). Secondary outcomes were non-cancer mortality (NCM) and cancer-specific mortality (CSM). Elevated NLR was defined as ≥2.27, elevated PLR as ≥165, and elevated De Ritis ratio as ≥ 2.72. Multivariable cox regression analysis (MVA) was conducted to elucidate risk factors for primary and secondary outcomes, and Kaplan-Meier analysis (KMA) was used to evaluate survival outcomes comparing elevated and non-elevated NLR, PLR, and De Ritis ratio.Results2656 patients were analyzed (874 patients had elevated NLR; 480 patients had elevated PLR and 932 patients had elevated De Ritis). Elevated NLR was a significant predictor of ACM (HR 1.32, 95% CI: 1.07-1.64, p=0.003) and NCM (HR 1.79, 95% CI: 1.30-2.46, p<0.001) in MVA. Elevated De Ritis was a significant predictor of ACM (HR 2.04, 95% CI: 1.65-2.52), NCM (HR 1.84, 95% CI: 1.33-2.55, p<0.001), and CSM (HR 1.97, 95% CI:1.48-2.63, p<0.001). KMA revealed significant difference in 5-year overall survival (OS) (48% vs. 68%, p<0.001), non-cancer survival (NCS) (69% vs. 87%, p<0.001), and cancer-specific survival (CSS) (60% vs. 73%, p<0.001) for elevated versus non-elevated NLR. For PLR, there was a difference in 5-year OS (51% vs. 61%, p<0.001) and CSS (60% vs. 73%, p<0.001) with KMA.ConclusionsElevated NLR was independently associated with worse ACM and NCM, while elevated De Ritis was predictive for CSM in addition to ACM and NCM. These differences may be useful in refining risk stratification with respect to cancer-related and non-cancer mortality in RCC patients and deserve further investigation.

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The platelet-to-lymphocyte ratio as a significant prognostic factor to predict survival outcomes in patients with synchronous metastatic renal cell carcinoma

Cited by 9 publications

References 28 publications

Prognostic significance of albumin-to-globulin ratio in patients with renal cell carcinoma: a meta-analysis

Prognostic significance of albumin-to-globulin ratio in patients with renal cell carcinoma: a meta-analysis

Identification of diagnostic and prognostic signatures derived from preoperative blood parameters for oral squamous cell carcinoma

Association of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and De Ritis ratio with mortality in renal cell carcinoma: A multicenter analysis

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