Neutrophil-to-Lymphocyte Ratio Predicts Cancer Outcome in Locally Advanced Clear Renal Cell Carcinoma.

Autor: Cordeiro MD; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil. Electronic address: mauriciocordeiro99@yahoo.com., Ilario EN; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Abe DK; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Carvalho PA; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Muniz DQB; Divisão de Oncologia, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Sarkis AS; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Coelho RF; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Guimarães RM; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Haddad MV; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil., Nahas WC; Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, Instituto do Câncer de Estado de São Paulo, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Clinical genitourinary cancer [Clin Genitourin Cancer] 2022 Apr; Vol. 20 (2), pp. 102-106. Date of Electronic Publication: 2021 Nov 22.
DOI: 10.1016/j.clgc.2021.10.009
Abstrakt: Background: To evaluate the association of neutrophil-to-lymphocyte ratio (NLR) with recurrence-free survival (RFS) and overall survival (OS) in patients with locally advanced nonmetastatic clear cell renal cell carcinoma (ccRCC) undergoing radical nephrectomy.
Material and Methods: We retrospectively identified 880 nephrectomies performed between January 2009 and December 2016 in a single center, reviewed data from 478 radical nephrectomies for kidney tumors and identified 187 patients with locally advanced nonmetastatic ccRCC (pT3-T4 N0M0). NLR was obtained preoperatively and calculated by dividing absolute neutrophil count by absolute lymphocyte count. OS and RFS were evaluated by the Kaplan-Meier method. Cox proportional-hazards regression models were used to evaluate predictors of RFS and OS.
Results: Among 187 patients with ccRCC (mean age 63.4 ± 11.5 years; 118 [63.1%] male), the median follow-up was 48.7 months. On univariate analysis, in patients with Fuhrman nuclear grade of differentiation 3-4, the median time to recurrence was significantly shorter with NLR ≥ 4 than < 4 (24 vs. 55 months, P = .045). On multivariable analysis adjusted for NLR ≥ 4, among all variables analyzed (NLR, microvascular invasion, sarcomatoid differentiation, tumor size and body mass index), only nuclear grade of differentiation was an independent predictor of recurrence (hazard ratio 2.18; 95% confidence interval 1.07-4.92, P = .03). The 3-year OS had no statistically significant difference between patients with NLR ≥ 4 or < 4.
Conclusion: For patients with locally advanced, nonmetastatic ccRCC, RFS was reduced with high nuclear grade of differentiation and high preoperative NLR. These findings suggest an association between higher NLR and worse outcomes in locally advanced ccRCC.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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