Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Nonmetastatic Renal Cell Carcinoma: A Large, Multicenter Cohort Analysis

Seok Soo Byun, Eu Chang Hwang, Seok Ho Kang, Sung Hoo Hong, Jinsoo Chung, Tae Gyun Kwon, Hyeon Hoe Kim, Cheol Kwak, Yong June Kim, Won Ki Lee

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Background. The prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) in nonmetastatic renal cell carcinoma (non-mRCC) is controversial, although NLR has been established as a prognostic factor in several cancers. The objective of our study was to assess the prognostic significance of preoperative NLR in non-mRCC, based on a large, multicenter cohort analysis. Methods. Totally, 1,284 non-mRCC patients undergoing surgery were enrolled from six institutions between 2000 and 2014. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were calculated, and the prognostic significance of NLR was evaluated. Results. Patients with higher NLR had larger tumors (p<0.001), higher T stage (p<0.001), worse Eastern Cooperative Oncology Group performance status (p<0.001), worse symptoms (p=0.003), sarcomatoid differentiation (p=0.004), and tumor necrosis (p<0.001). The 5-year RFS and CSS rates were significantly lower in patients with high NLR than in those with low NLR (each p<0.001). Multivariate analysis identified NLR to be an independent predictor of RFS and CSS (each p<0.05). Moreover, predictive accuracy of multivariate models for RFS and CSS increased by 2.2% and 4.2%, respectively, with NLR inclusion. Conclusions. Higher NLR was associated with worse clinical behavior of non-mRCC. Also, NLR was a significant prognostic factor of both RFS and CSS.

Original languageEnglish
Article number5634148
JournalBioMed Research International
StatePublished - 2016

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