Prognostic Impact of Preoperative Neutrophil-to-Lymphocyte Ratio in Localized Nonclear Cell Renal Cell Carcinoma

Abstract

No AccessJournal of UrologyAdult Urology1 Dec 2013Prognostic Impact of Preoperative Neutrophil-to-Lymphocyte Ratio in Localized Nonclear Cell Renal Cell Carcinoma Michela de Martino, Allan J. Pantuck, Sebastian Hofbauer, Matthias Waldert, Shahrokh F. Shariat, Arie S. Belldegrun, and Tobias Klatte Michela de MartinoMichela de Martino , Allan J. PantuckAllan J. Pantuck , Sebastian HofbauerSebastian Hofbauer , Matthias WaldertMatthias Waldert , Shahrokh F. ShariatShahrokh F. Shariat , Arie S. BelldegrunArie S. Belldegrun , and Tobias KlatteTobias Klatte View All Author Informationhttps://doi.org/10.1016/j.juro.2013.06.082AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The preoperative neutrophil-to-lymphocyte ratio was proposed as a prognostic factor for localized clear cell renal cell carcinoma. We evaluated its role in nonclear cell renal cell carcinoma. Materials and Methods: We queried 2 prospective kidney cancer databases. Patients who underwent full resection of localized (T1-3 N0/+ M0) nonclear cell renal cell carcinoma by radical or partial nephrectomy were included in analysis. Associations of the continuously coded neutrophil-to-lymphocyte ratio with disease-free survival were assessed with univariable and multivariable Cox regression models. Prognostic accuracy was evaluated with the Harrell concordance index. Results: Our final cohort included 281 patients. The 5-year disease-free survival rate was 88.1%. The neutrophil-to-lymphocyte ratio was significantly associated with disease-free survival. With each 1.0 increase in the ratio the risk of recurrence increased by 15% (HR 1.15, p = 0.028). On multivariable analysis TNM group (HR 2.84, p = 0.025), Fuhrman grade (HR 3.40, p <0.001) and the neutrophil-to-lymphocyte ratio (HR 1.17, p = 0.022) were independently associated with disease-free survival. Adding the neutrophil-to-lymphocyte ratio improved the accuracy of a base model to predict disease-free survival from 78.8% to 80.8%. Conclusions: The neutrophil-to-lymphocyte ratio is an independent prognostic factor for disease-free survival after surgery with curative intent for localized nonclear cell renal cell carcinoma. It significantly increases the accuracy of established prognostic factors. The neutrophil-to-lymphocyte ratio may provide a meaningful adjunct for patient counseling and clinical trial design. References 1 : Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol2002; 20: 4559. Google Scholar 2 : Late recurrence of renal cell carcinoma >5 years after surgery: clinicopathological characteristics and prognosis. BJU Int2012; 110: E553. 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Pantuck More articles by this author Sebastian Hofbauer More articles by this author Matthias Waldert More articles by this author Shahrokh F. Shariat More articles by this author Arie S. Belldegrun More articles by this author Tobias Klatte More articles by this author Expand All Advertisement PDF DownloadLoading ...