Critical evaluation of the potential prognostic value of the pretreatment-derived neutrophil-lymphocyte ratio under consideration of C-reactive protein levels in clear cell renal cell carcinoma.

Autor: Dalpiaz O; Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, Graz A-8036, Austria., Luef T; Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, Graz A-8036, Austria., Seles M; Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, Graz A-8036, Austria., Stotz M; Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 25, Graz A-8036, Austria., Stojakovic T; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, Graz A-8036, Austria., Pummer K; Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, Graz A-8036, Austria., Zigeuner R; Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, Graz A-8036, Austria., Hutterer GC; Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, Graz A-8036, Austria., Pichler M; Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 25, Graz A-8036, Austria.; Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, South Campus Research Building 4, 1901 East Road, Houston, TX 77054, USA.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2017 Jan 03; Vol. 116 (1), pp. 85-90. Date of Electronic Publication: 2016 Dec 01.
DOI: 10.1038/bjc.2016.393
Abstrakt: Background: We investigated the prognostic value of the pretreatment-derived neutrophil-lymphocyte ratio (dNLR) and original NLR in relation to the commonly used inflammation marker C-reactive protein (CRP) in a large cohort of patients with clear cell renal cell carcinoma (RCC).
Methods: Clinicopathological data from 587 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single tertiary academic center, were evaluated retrospectively. Patients were categorised according to a cutoff value derived from receiver operating curve analysis. Overall (OS), cancer-specific (CSS) as well as metastasis-free survival (MFS) were assessed using the Kaplan-Meier method and multivariate Cox proportional models were applied. Spearman's rank correlation coefficient tested the association between dNLR and other markers of the systemic inflammatory response.
Results: The significant correlation between pretreatment NLR and dNLR was strong (ρ=0.84), whereas between dNLR and CRP it was weak (ρ=0.18). In multivariate analyses, dNLR achieved independent predictor status regarding CSS (P=0.037) and MFS (P=0.041), whereas CRP was confirmed as independent predictor of OS (P=0.010), CSS (P=0.039) and MFS (P=0.005), respectively. The NLR failed to reach independent predictor status regarding OS, CSS and MFS when CRP was included into the multivariate model.
Conclusions: In the cohort studied, an elevated (⩾10.0) pretreatment CRP level and elevated dNLR (>2) were robust independent predictors of CSS and MFS. Our data suggest that CRP might be superior to both NLR and dNLR.
Databáze: MEDLINE
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