The Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients with Metastatic Renal Cell Carcinoma

Paroşanu, Andreea; Pirlog, Cristina; Slavu, Cristina Orlov; Stanciu, Ioana Miruna; Cotan, Horia-Teodor; Vrabie, Radu Constantin; Popa, Ana Maria; Olaru, Mihaela; Iaciu, Cristian; Bratu, Lucian Ioan; Baicoianu, Ionut Florian; Moldoveanu, Oana; Baston, C.; Nițipir, Cornelia

doi:10.3390/curroncol30020187

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…Specifically, greater NLR correlates with worse outcomes in both non-metastatic and metastatic RCC. 11,12,[20][21][22] While most of these studies do not focus on RCC with a tumor thrombus, two recent papers have. Nagamoto et al 11 looked at patients with RCC and an IVC thrombus and concluded that a NLR ⩾ 2.9 was an independent predictor of poor 5-year cancer-specific survival and overall survival.…”

Section: Discussionmentioning

confidence: 99%

The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

Sandberg,

Namugosa,

Ritts

et al. 2024

Urologia

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Introduction: The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy. Methods: Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples t-test, Pearson’s bivariate correlation, and analysis of variance. Results: One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; p < 0.001). Patients with tumor pathology showing perirenal fat invasion had a greater neutrophil count compared to those who did not (7.5 vs 5.5; p = 0.010). Patients with metastatic RCC had a lower LMR compared to those without metastases after surgery (2.5 vs 3.2; p = 0.041). Tumor size, both preoperatively and on gross specimen, had an interaction with multiple immune cell metrics ( p < 0.05). Conclusions: Preoperative immune metrics have clinical utility in predicting cancer-specific outcomes for patients with RCC and a tumor thrombus. Additional study is needed to determine the added value of preoperative serum immune cell data to established prognostic risk calculators for this patient population.

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Section: Discussionmentioning

confidence: 99%

The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

Sandberg,

Namugosa,

Ritts

et al. 2024

Urologia

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“…The normal range of NLR in healthy adults varies between 1 and 3. Values higher than three are considered pathological [47][48][49][50]. Therefore, it is essential to find a cut-off value to mark the lower and the upper limit of NLR associated with prognosis.…”

Section: Discussionmentioning

confidence: 99%

Second-Line Treatment of Metastatic Renal Cell Carcinoma in the Era of Predictive Biomarkers

et al. 2023

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Background: Over the past few years, significant advancements have been achieved in the front-line treatment of metastatic renal cell carcinomas (mRCCs). However, most patients will eventually encounter disease progression during this front-line treatment and require further therapeutic options. While treatment choices for mRCCs patients are determined by established risk classification models, knowledge of prognostic factors in subsequent line therapy is essential in patient care. Methods: In this retrospective, single-center study, patients diagnosed with mRCCs who experienced progression after first-line therapy were enrolled. Fifteen factors were analyzed for their prognostic impact on survival using the Kaplan–Meier method and the Cox proportional hazards model. Results: Poor International Metastatic RCCs Database Consortium (IMDC) and Memorial Sloan-Kettering Cancer Center (MSKCC) risk scores, NLR value > 3, clinical benefit < 3 months from a therapeutic line, and the presence of sarcomatoid differentiation were found to be poor independent prognostic factors for shortened overall survival. Conclusions: This study provided new insights into the identification of potential prognostic parameters for late-line treatment in mRCCs. The results indicated that good IMDC and MSKCC prognostic scores are effective in second-line therapy. Moreover, patients with NLR < 3, no sarcomatoid differentiation, and clinical benefit > 3 months experienced significantly longer overall survival.

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“…Large multi-center studies are needed to confirm these findings. These years, some systemic inflammatory and immune response indicators such as C-reactive protein and neutrophil to lymphocyte ratio (NLR) were considered to predict prognosis ( 32 ). Our nomogram included preoperative neutrophils, which was one of independent risk factor of OS.…”

Section: Discussionmentioning

confidence: 99%

Construction of the prognostic model in non-metastatic renal cancer patients with venous tumor thrombus

Zhu,

Yang,

Huangfu

et al. 2023

Transl Androl Urol

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Background Venous system invasion is a prominent characteristic of local progression in renal cancer and treatment-naïve renal cancer patients with venous tumor thrombus (VTT) gained short natural course and poor prognosis. This study aimed to investigate the efficacy of the surgery and prognostic factors in non-metastatic renal cancer patients with VTT and to construct a nomogram prognostic model. Methods Clinical data of 114 non-metastatic renal cancer patients with VTT who underwent surgical treatment from January 2011 to September 2022 were retrospectively analyzed. In order to find independent risk factors of prognosis, survival analysis was performed via univariate and multivariate Cox regression models and Kaplan-Meier method. Nomogram prognostic model was established to calculate patients’ risk scores. Receiver operating characteristic curve and decision curve analysis were conducted to evaluate the efficacy of the prognostic model. Results A total of 114 patients were included in this study and there were 48, 12, 25, 23, and 6 cases of grade 0–IV VTT. No perioperative death occurred. The 3-year probabilities of overall survival (OS) and 5-year probabilities of OS were 67% and 43.8%, respectively. Multivariate Cox regression analysis revealed that kidney tumor diameter, preoperative lactate dehydrogenase (LDH), and preoperative neutrophils were independent risk factors. Nomogram was constructed to predict prognosis in renal cancer patients with VTT based on above indicators and Mayo VTT grading. The area under the ROC curve of 1-, 2-, 3-, and 5-year OS of the patients were 0.82, 0.67, 0.57, and 0.55 respectively. Conclusions Surgical treatment enables renal cancer patients with VTT to gain a better prognosis. Kidney tumor diameter, preoperative LDH, and preoperative neutrophils were independent risk factors. The nomogram perfects the Mayo grading, and provides a reliable reference for evaluation of prognosis of renal cancer patients with VTT.

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The Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients with Metastatic Renal Cell Carcinoma

Cited by 7 publications

References 27 publications

The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

Second-Line Treatment of Metastatic Renal Cell Carcinoma in the Era of Predictive Biomarkers

Construction of the prognostic model in non-metastatic renal cancer patients with venous tumor thrombus

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