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Pretreatment neutrophil-to-lymphocyte ratio predicts prognosis in patients with metastatic renal cell carcinoma receiving targeted therapy

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Abstract

Background

The neutrophil-to-lymphocyte ratio (NLR) is associated with clinical outcomes of various cancers. This study aimed to evaluate whether pretreatment NLR can be used as a prognostic factor in patients with metastatic renal cell carcinoma (mRCC) receiving targeted therapy.

Methods

In this single-center retrospective study, the Kaplan–Meier method was used to estimate progression-free survival (PFS) and overall survival (OS) of 373 mRCC patients receiving targeted therapy. The survival outcomes of patients with high (≥2.2) and low (<2.2) pretreatment NLRs were compared by log-rank test, and Cox proportional hazard regression model was used to compare OS and PFS between groups.

Results

The overall median PFS and OS times for all 373 patients were 18.4 and 34.3 months, respectively. Patients with high NLRs had significantly shorter median OS (28.8 vs 410 months, P = 0.005) and PFS (15.4 vs 23.9 months, P = 0.001) than those with low NLRs. After adjusting for confounding variables, each unit increase of NLR was associated with a 40 % increase in mortality (hazard ratio [HR] 1.391; 95 % confidence interval [CI] 1.022–1.894; P = 0.036). High NLR was also an independent predictor of poor PFS (HR 1.544; 95 % CI 1.166–2.045; P = 0.002).

Conclusion

Pretreatment NLR may be an independent prognostic factor for mRCC patients who are receiving targeted therapy.

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References

  1. Gupta K, Miller JD, Li JZ et al (2008) Epidemiologic and socioeconomic burden of metastatic renal cell carcinoma (mRCC): a literature review. Cancer Treat Rev 34:193–205

    Article  PubMed  Google Scholar 

  2. Athar U, Gentile TC (2008) Treatment options for metastatic renal cell carcinoma: a review. Can J Urol 15:3954–3966

    PubMed  Google Scholar 

  3. Hanahan D, Weinberg RA (2011) Hallmarks of cancer: the next generation. Cell 144:646–674

    Article  CAS  PubMed  Google Scholar 

  4. Shin JH, Kim CJ, Jeon EJ et al (2015) Overexpression of C-reactive protein as a poor prognostic marker of resectable hepatocellular carcinomas. J Pathol Transl Med 49:105–111

    Article  PubMed  PubMed Central  Google Scholar 

  5. Beuselinck B, Vano YA, Oudard S et al (2014) Prognostic impact of baseline serum C-reactive protein in patients with metastatic renal cell carcinoma (RCC) treated with sunitinib. BJU Int 114:81–89

    Article  CAS  PubMed  Google Scholar 

  6. Han S, Huang Y, Li Z et al (2015) The prognostic role of preoperative serum albumin levels in glioblastoma patients. BMC Cancer 15:108

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ito H, Shioi K, Murakami T et al (2012) C-reactive protein in patients with advanced metastatic renal cell carcinoma: usefulness in identifying patients most likely to benefit from initial nephrectomy. BMC Cancer 12:337

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Wei X, Huang F, Wei Y et al (2014) Low lymphocyte-to-monocyte ratio predicts unfavorable prognosis in non-germinal center type diffuse large B-cell lymphoma. Leuk Res 38:694–698

    Article  PubMed  Google Scholar 

  9. Pichler M, Hutterer GC, Stoeckigt C et al (2013) Validation of the pre-treatment neutrophil–lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients. Br J Cancer 108:901–907

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Park YH, Ku JH, Kwak C et al (2014) Post-treatment neutrophil-to-lymphocyte ratio in predicting prognosis in patients with metastatic clear cell renal cell carcinoma receiving sunitinib as first line therapy. Springerplus 3:243

    Article  PubMed  PubMed Central  Google Scholar 

  11. Gunduz S, Mutlu H, Uysal M et al (2014) Prognostic value of hematologic parameters in patients with metastatic renal cell carcinoma using tyrosine kinase inhibitors. Asian Pac J Cancer Prev 15:3801–3804

    Article  PubMed  Google Scholar 

  12. Heng DY, **e W, Regan MM et al (2013) External validation and comparison with other models of the international metastatic renal-cell carcinoma database consortium prognostic model: a population-based study. Lancet Oncol 14:141–148

    Article  PubMed  PubMed Central  Google Scholar 

  13. Vakkila J, Lotze MT (2004) Inflammation and necrosis promote tumour growth. Nat Rev Immunol 4:641–648

    Article  CAS  PubMed  Google Scholar 

  14. Kaynar M, Yildirim ME, Badem H et al (2014) Bladder cancer invasion predictability based on preoperative neutrophil–lymphocyte ratio. Tumour Biol 35:6601–6605

    Article  PubMed  Google Scholar 

  15. Dalpiaz O, Ehrlich GC, Mannweiler S et al (2014) Validation of pretreatment neutrophil–lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma. BJU Int 114:334–339

    PubMed  Google Scholar 

  16. Chen J, Hong D, Zhai Y et al (2015) Meta-analysis of associations between neutrophil-to-lymphocyte ratio and prognosis of gastric cancer. World J Surg Oncol 13:122

    Article  PubMed  PubMed Central  Google Scholar 

  17. Keizman D, Ish-Shalom M, Huang P et al (2012) The association of pre-treatment neutrophil to lymphocyte ratio with response rate, progression free survival and overall survival of patients treated with sunitinib for metastatic renal cell carcinoma. Eur J Cancer 48:202–208

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Santoni M, De Giorgi U, Iacovelli R et al (2013) Pre-treatment neutrophil-to-lymphocyte ratio may be associated with the outcome in patients treated with everolimus for metastatic renal cell carcinoma. Br J Cancer 109:1755–1759

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Heng DY, **e W, Regan MM et al (2009) Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor–targeted agents: results from a large, multicenter study. J Clin Oncol 27:5794–5799

    Article  CAS  PubMed  Google Scholar 

  20. Pensa M, Swede H, Brockmeyer JA et al (2009) Patterns of HER2 testing in the management of primary breast cancer. Cancer Epidemiol 33:113–117

    Article  PubMed  Google Scholar 

  21. Garcia-Donas J, Esteban E, Leandro-Garcia LJ et al (2011) Single nucleotide polymorphism associations with response and toxic effects in patients with advanced renal-cell carcinoma treated with first-line sunitinib: a multicentre, observational, prospective study. Lancet Oncol 12:1143–1150

    Article  CAS  PubMed  Google Scholar 

  22. Ye DW, Zhang HL (2014) Critical appraisal of sorafenib in the treatment of Chinese patients with renal cell carcinoma. Onco Targets Ther 7:925–935

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Weitzman SA, Gordon LI (1990) Inflammation and cancer: role of phagocyte-generated oxidants in carcinogenesis. Blood 76:655–663

    CAS  PubMed  Google Scholar 

  24. Kusumanto YH, Dam WA, Hospers GA et al (2003) Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis 6:283–287

    Article  CAS  PubMed  Google Scholar 

  25. Mantovani A, Allavena P, Sica A et al (2008) Cancer-related inflammation. Nature 454:436–444

    Article  CAS  PubMed  Google Scholar 

  26. Rosenberg SA (2001) Progress in human tumour immunology and immunotherapy. Nature 411:380–384

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported in part by grants from the National Natural Science Foundation of China (Grant No. NSFC 81001131).

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    Authors and Affiliations

    1. Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong’an Rd, Shanghai, 200032, People’s Republic of China

      Gui-Ming Zhang, Yao Zhu, Wei-Jie Gu, Hai-Liang Zhang, Guo-Hai Shi & Ding-Wei Ye

    2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

      Gui-Ming Zhang, Yao Zhu, Wei-Jie Gu, Hai-Liang Zhang, Guo-Hai Shi & Ding-Wei Ye

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    1. Gui-Ming Zhang
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    2. Yao Zhu
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    Correspondence to Ding-Wei Ye.

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    G. - M. Zhang and Y. Zhu contribute equally to the work.

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    Zhang, GM., Zhu, Y., Gu, WJ. et al. Pretreatment neutrophil-to-lymphocyte ratio predicts prognosis in patients with metastatic renal cell carcinoma receiving targeted therapy. Int J Clin Oncol 21, 373–378 (2016). https://doi.org/10.1007/s10147-015-0894-4

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    • DOI: https://doi.org/10.1007/s10147-015-0894-4

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