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Nakayama T, Takeshita H, Kagawa M, Washino S, Shirotake S, Miura Y, Hyodo Y, Izumi K, Inoue M, Matsuoka Y, Miyagawa T, Oyama M, Saito K, Kawakami S. Prognostic significance of inflammatory markers in patients with advanced renal cell carcinoma receiving nivolumab plus ipilimumab. Int J Clin Oncol 2024:10.1007/s10147-024-02593-1. [PMID: 39046676 DOI: 10.1007/s10147-024-02593-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/17/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND A useful biomarker for the efficacy of immune checkpoint inhibitors (ICIs) in advanced renal cell carcinoma (RCC) has not yet been established. This study aims to investigate whether inflammatory markers are associated with the efficacy of nivolumab plus ipilimumab therapy before and during treatment. METHODS Data from patients with advanced clear cell RCC who received a combination treatment of nivolumab plus ipilimumab were retrospectively analyzed. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) levels were assessed at baseline and 3, 6, and 9 weeks after treatment initiation. The correlation between these inflammatory markers and the patient's prognosis was investigated. RESULTS Eighty-four patients were identified. The multivariate analysis identified NLR at week 3, CRP at week 6, and NLR and CRP at week 9 as the consistent predictor associated with poor overall survival (OS) at each time point. The survival analysis and receiver operating characteristic (ROC) curve analysis revealed that an NLR of ≥ 2.4 at week 3, CRP of ≥ 1.4 mg/dL at week 6, and NLR of ≥ 4.8 and CRP of ≥ 1.0 mg/dL at week 9 were associated with worse OS (hazard ratios (HR) = 5.70, P = 0.008, HR = 3.23, P = 0.004, HR = 7.38, P < 0.001 and HR = 3.55, P = 0.002). CONCLUSIONS Both NLR and CRP were considered useful biomarkers for understanding the prognosis during nivolumab plus ipilimumab therapy. Furthermore, an NLR of ≥ 4.8 and CRP of ≥ 1.0 mg/dL at week 9 are helpful in reconsidering treatment continuation.
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Affiliation(s)
- Takayuki Nakayama
- Department of Urology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
- Musashinno Study Group, Saitama, Japan
| | - Hideki Takeshita
- Department of Urology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
- Musashinno Study Group, Saitama, Japan.
| | - Makoto Kagawa
- Department of Urology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
- Musashinno Study Group, Saitama, Japan
| | - Satoshi Washino
- Department of Urology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
- Musashinno Study Group, Saitama, Japan
| | - Suguru Shirotake
- Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
- Musashinno Study Group, Saitama, Japan
| | - Yuji Miura
- Department of Medical Oncology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
- Musashinno Study Group, Saitama, Japan
| | - Yoji Hyodo
- Department of Urology, Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan
- Musashinno Study Group, Saitama, Japan
| | - Keita Izumi
- Department of Urology, Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan
- Musashinno Study Group, Saitama, Japan
| | - Masaharu Inoue
- Department of Urology, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
- Musashinno Study Group, Saitama, Japan
| | - Yoh Matsuoka
- Department of Urology, Saitama Cancer Center, 780 Komuro, Ina-machi, Kita-Adachi-gun, Saitama, 362-0806, Japan
| | - Tomoaki Miyagawa
- Department of Urology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Masafumi Oyama
- Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Kazutaka Saito
- Department of Urology, Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan
| | - Satoru Kawakami
- Department of Urology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
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Tustumi F, Pereira MA, Lisak AS, Ramos MFKP, Ribeiro Junior U, Dias AR. THE VALUE OF PREOPERATIVE PROGNOSTIC NUTRITIONAL INDEX IN GASTRIC CANCER AFTER CURATIVE RESECTION. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2024; 37:e1805. [PMID: 38896701 PMCID: PMC11182628 DOI: 10.1590/0102-6720202400012e1805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 03/23/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Predicting short- and long-term outcomes of oncological therapies is crucial for developing effective treatment strategies. Malnutrition and the host immune status significantly affect outcomes in major surgeries. AIMS To assess the value of preoperative prognostic nutritional index (PNI) in predicting outcomes in gastric cancer patients. METHODS A retrospective cohort analysis was conducted on patients undergoing curative-intent surgery for gastric adenocarcinoma between 2009 and 2020. PNI was calculated as follows: PNI=(10 x albumin [g/dL])+(0.005 x lymphocytes [nº/mm3]). The optimal cutoff value was determined by the receiver operating characteristic curve (PNI cutoff=52), and patients were grouped into low and high PNI. RESULTS Of the 529 patients included, 315 (59.5%) were classified as a low-PNI group (PNI<52) and 214 (40.5%) as a high-PNI group (PNI≥52). Older age (p=0.050), male sex (p=0.003), American Society of Anesthesiologists score (ASA) III/IV (p=0.001), lower hemoglobin level (p<0.001), lower body mass index (p=0.001), higher neutrophil-lymphocyte ratio (p<0.001), D1 lymphadenectomy, advanced pT stage, pN+ and more advanced pTNM stage were related to low-PNI patient. Furthermore, 30-day (1.4 vs. 4.8%; p=0.036) and 90-day (3.3 vs. 10.5%; p=0.002) mortality rates were higher in low-PNI compared to high-PNI group. Disease-free and overall survival were worse in low-PNI patients compared to high-PNI (p<0.001 for both). ASA III/IV score, low-PNI, pT3/T4, and pN+ were independent risk factors for worse survival. CONCLUSIONS Preoperative PNI can predict short- and long-term outcomes of patients with gastric cancer after curative gastrectomy. Low PNI is an independent factor related to worse disease-free and overall survival.
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Affiliation(s)
- Francisco Tustumi
- Universidade de São Paulo, Hospital das Clínicas, Instituto do Câncer do Estado de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil
| | - Marina Alessandra Pereira
- Universidade de São Paulo, Hospital das Clínicas, Instituto do Câncer do Estado de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil
| | - André Safatle Lisak
- Universidade de São Paulo, Hospital das Clínicas, Instituto do Câncer do Estado de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil
| | - Marcus Fernando Kodama Pertille Ramos
- Universidade de São Paulo, Hospital das Clínicas, Instituto do Câncer do Estado de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil
| | - Ulysses Ribeiro Junior
- Universidade de São Paulo, Hospital das Clínicas, Instituto do Câncer do Estado de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil
| | - André Roncon Dias
- Universidade de São Paulo, Hospital das Clínicas, Instituto do Câncer do Estado de São Paulo, Department of Gastroenterology - São Paulo (SP), Brazil
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Hammad R, Selim M, Eldosoky MA, Elmadbouly AA, Abd El Hakam FEZ, Elshafei A, Fawzy M, Hammad M. Contribution of plasma MicroRNA-21, MicroRNA-155 and circulating monocytes plasticity to childhood neuroblastoma development and induction treatment outcome. Pathol Res Pract 2024; 254:155060. [PMID: 38194805 DOI: 10.1016/j.prp.2023.155060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/11/2024]
Abstract
Neuroblastoma (NB) accounts for 15% of all pediatric cancer fatalities (NB). Biomarkers that facilitate early NB detection are needed because by the time of diagnosis, over half of NBs had spread. MicroRNA-21(miR-21) and miR-155 are involved in cancer biology due to their immune modulation functions. Altered monocyte subset distribution is thought to be involved in a number of solid tumors due to its immunological role. We aimed to investigate the expression levels of miR-21 and miR-155 and their association with circulating monocytes subsets in NB and to evaluate if they correlate to the disease pathogenesis and outcome. PATIENTS AND METHODS This case control study involved 79 children classified into 39 newly diagnosed NB children and 40 age and sex matched healthy children. Real-time PCR was used to assess the expression of plasma miR-21 and miR-155. The frequency of circulating monocytes subsets was assessed by flow cytometry. RESULTS NB group showed significant up-regulation in expression of miR-21(20.9 folds) and miR-155 (1.8 folds) when compared to the control group (p < 0.001) and (p = 0.02) respectively. Also, frequency of circulating intermediate monocytes revealed significant up regulation in children with NB. In NB patients, there was a positive correlation between miR-21 and frequency of total and intermediate monocytes (r = 0.5 p < 0.001 and r = 0.7, p < 0.001, respectively). We found no discernible differences when we compared study markers between the high risk and intermediate risk groups. In addition, no significant difference was seen in study markers when patients were sub-grouped according to their induction treatment response. ROC curve analysis revealed that miR-21 up-regulation distinguished NB in childhood at an AUC of 0.94 (82% sensitivity and 100% specificity) while miR-155 up-regulation had less capacity to distinguish NB in childhood at an AUC of 0.65 (38% sensitivity and 93% specificity). CONCLUSION miR-21 can be utilized as a sensitive biomarker for childhood NB development. In pediatric NB, miR-21 was linked to intermediate monocyte plasticity. Both, miR-21 and miR-155 had no impact on NB outcome.
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Affiliation(s)
- Reham Hammad
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mustafa Selim
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Egypt
| | - Mona A Eldosoky
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Asmaa A Elmadbouly
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
| | | | - Ahmed Elshafei
- Biochemistry & Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, Egypt
| | - Mohamed Fawzy
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Egypt
| | - Mahmoud Hammad
- Pediatric Oncology Department, National Cancer Institute, Cairo University, Egypt
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Horie S, Naito S, Hatakeyama S, Kandori S, Numakura K, Kato R, Koguchi T, Myoen S, Kawasaki Y, Ito A, Adachi H, Kojima Y, Obara W, Habuchi T, Nishiyama H, Ohyama C, Tsuchiya N. Preoperative prognostic model for localized and locally advanced renal cell carcinoma: Michinoku Japan Urological Cancer Study Group. Int J Clin Oncol 2023; 28:1538-1544. [PMID: 37740070 DOI: 10.1007/s10147-023-02401-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/06/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND The Modified International Metastatic Renal Cell Carcinoma Dataset Consortium model (mIMDC) is a preoperative prognostic model for pT3cN0M0 renal cell carcinoma (RCC). This study aimed to validate the mIMDC and to construct a new model in a localized and locally advanced RCC (LLRCC). METHODS A database was established (the Michinoku Japan Urological Cancer Study Group database) consisting of 79 patients who were clinically diagnosed with LLRCC (cT3b/c/4NanyM0) and underwent radical nephrectomy from December 2007 to May 2018. Using univariable and multivariable analyses, we retrospectively analyzed disease-free survival (DFS) and overall survival (OS) in this database, constructed a new prognostic model according to these results, and estimated the model fit using c-index on the new and mIMDC models. RESULTS Independent poorer prognostic factors for both DFS and OS include the following: ≥ 1 Eastern Cooperative Oncology Group performance status, 2.0 mg/dL C-reactive protein, and > upper normal limit of white blood cell count. The median DFS in the favorable (no factor), intermediate (one factor), and poor-risk group (two or three factors) was 76.1, 14.3, and 4.0 months, respectively (P < 0.001). The 3-year OS in the favorable, intermediate, and poor-risk group were 92%, 44%, and 0%, respectively (P < 0.001). The c-indices of the new and mIMDC models were 0.67 and 0.60 for DFS (P = 0.060) and 0.74 and 0.63 for OS (P = 0.012), respectively. CONCLUSION The new preoperative prognostic model in LLRCC can be used in patient care and clinical trials.
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Affiliation(s)
- Shigemitsu Horie
- Department of Urology, Faculty of Medicine, Yamagata University, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan
| | - Sei Naito
- Department of Urology, Faculty of Medicine, Yamagata University, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan.
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 0368562, Japan
| | - Shuya Kandori
- Department of Urology, University of Tsukuba Graduate School of Medicine, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
| | - Kazuyuki Numakura
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Renpei Kato
- Department of Urology, Iwate Medical University School of Medicine, Yahaba 2-1-1, Shiwa, Iwate, 028-3695, Japan
| | - Tomoyuki Koguchi
- Department of Urology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Shingo Myoen
- Department of Urology, Miyagi Cancer Center, 47-1 Nodayama, Shiote, Medeshima, Natori, Miyagi, 981-1293, Japan
| | - Yoshihide Kawasaki
- Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Akihiro Ito
- Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan
| | - Hisanobu Adachi
- Department of Urology, Miyagi Cancer Center, 47-1 Nodayama, Shiote, Medeshima, Natori, Miyagi, 981-1293, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Wataru Obara
- Department of Urology, Iwate Medical University School of Medicine, Yahaba 2-1-1, Shiwa, Iwate, 028-3695, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, University of Tsukuba Graduate School of Medicine, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 0368562, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Faculty of Medicine, Yamagata University, Iida-Nishi 2-2-2, Yamagata, 990-9585, Japan
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Lee J, Yoo S, Choo MS, Cho MC, Son H, Jeong H. Prognostic Role of Preoperative Neutrophil-To-Lymphocyte Ratio (NLR) and Recurrence at First Evaluation after Bacillus Calmette-Guérin (BCG) Induction in Non-Muscle-Invasive Bladder Cancer. Diagnostics (Basel) 2023; 13:3114. [PMID: 37835857 PMCID: PMC10572862 DOI: 10.3390/diagnostics13193114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
We investigated the prognosis of BCG induction-only treatment and non-complete response (CR) at the first 3-month evaluation and examined factors associated with CR. In total, 209 patients with moderate- and high-risk NMIBC who received BCG induction-only treatment between 2008 and 2020 were retrospectively analyzed. Recurrence-free survival (RFS) and progression-free survival (PFS) were assessed based on the initial NMIBC stage. PFS and associated factors of non-CR compared to CR were also assessed. Initial T1 high-grade (HG) (n = 93) had poorer RFS and PFS after BCG induction-only treatment than Ta low-grade (LG) (p = 0.029, p = 0.002). Non-CR (n = 37) had a different neutrophil-to-lymphocyte ratio (NLR) (2.81 ± 1.02 vs. 1.97 ± 0.92) and T staging from CR (p < 0.001, p = 0.008). T1HG recurrence was associated with a worse PFS compared to non-T1HG (13.7 months vs. 101.7 months, p < 0.001). There was no difference in PFS between T1HG and T1LG. T1 and NLR were predictors of response at 3 months in multivariable analysis (p = 0.004, p = 0.029). NLR was also found to be an associated factor with RFS and PFS of bladder cancer (p < 0.001, p < 0.001). BCG induction-only treatment was effective for high-risk TaLG but not for T1HG. T1HG recurrence at 3 months after BCG induction has a poor prognosis for bladder cancer. Preoperative NLR and T1 were predictors of non-CR, and NLR was also associated with the long-term prognosis of bladder cancer.
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Affiliation(s)
- Junghoon Lee
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Sangjun Yoo
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Min Soo Choo
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Min Chul Cho
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
| | - Hwancheol Son
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
- Institute for Peace and Unification Studies, Seoul National University, Seoul 08826, Republic of Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (J.L.)
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Asif A, Chan VWS, Osman FH, Koe JSE, Ng A, Burton OE, Cartledge J, Kimuli M, Vasudev N, Ralph C, Jagdev S, Bhattarai S, Smith J, Lenton J, Wah TM. The Prognostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Small Renal Cell Carcinomas after Image-Guided Cryoablation or Radio-Frequency Ablation. Cancers (Basel) 2023; 15:cancers15072187. [PMID: 37046847 PMCID: PMC10093520 DOI: 10.3390/cancers15072187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 03/21/2023] [Accepted: 03/25/2023] [Indexed: 04/08/2023] Open
Abstract
There is a lack of cheap and effective biomarkers for the prediction of renal cancer outcomes post-image-guided ablation. This is a retrospective study of patients with localised small renal cell cancer (T1a or T1b) undergoing cryoablation or radiofrequency ablation (RFA) at our institution from 2003 to 2016. A total of 203 patients were included in the analysis. In the multivariable analysis, patients with raised neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) pre-operatively, post-operatively and peri-operatively are associated with significantly worsened cancer-specific survival, overall survival and metastasis-free survival. Furthermore, an increased PLR pre-operatively is also associated with increased odds of a larger than 25% drop in renal function post-operatively. In conclusion, NLR and PLR are effective prognostic factors in predicting oncological outcomes and peri-operative outcomes; however, larger external datasets should be used to validate the findings prior to clinical application.
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Affiliation(s)
- Aqua Asif
- Royal Surrey NHS Foundation Trust, Surrey GU2 7XX, UK
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, UK
| | - Vinson Wai-Shun Chan
- Division of Surgery and Interventional Science, University College London, London WC1E 6BT, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK
- Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK
| | - Filzah Hanis Osman
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK
| | | | - Alexander Ng
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
| | - Oliver Edward Burton
- School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Jon Cartledge
- Department of Urology, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - Michael Kimuli
- Department of Urology, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - Naveen Vasudev
- Department of Medical Oncology, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - Christy Ralph
- Department of Medical Oncology, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - Satinder Jagdev
- Department of Medical Oncology, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - Selina Bhattarai
- Department of Pathology, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - Jonathan Smith
- Department of Diagnostic and Interventional Radiology, Institute of Oncology, Leeds Teaching Hospitals Trust, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - James Lenton
- Department of Diagnostic and Interventional Radiology, Institute of Oncology, Leeds Teaching Hospitals Trust, St. James’s University Hospital, Leeds LS9 7TF, UK
| | - Tze Min Wah
- Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK
- Department of Diagnostic and Interventional Radiology, Institute of Oncology, Leeds Teaching Hospitals Trust, St. James’s University Hospital, Leeds LS9 7TF, UK
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Cesur IB, Özçelik Z. Systemic Immune-Inflammation Index May Predict Mortality in Neuroblastoma. Cureus 2023; 15:e35705. [PMID: 36875247 PMCID: PMC9982472 DOI: 10.7759/cureus.35705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Neuroblastomas (NB) are among the most frequent childhood solid tumors. The link between inflammation and cancer is well understood. Many research studies have been conducted to determine the prognostic importance of inflammatory markers in cancer patients. C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are all potential inflammation indicators. The purpose of this study is to assess the efficacy of NLR and SII as inflammatory indicators in predicting NB patient survival. MATERIALS AND METHODS Patients with NB diagnosed between January 1, 2012 and December 31, 2021 were studied retrospectively, and death was documented. By dividing the number of neutrophils by the number of lymphocytes, the NLR was obtained. The SII was calculated by multiplying the NLR by the platelet count. RESULTS 46 patients with NB were included in the study with a mean age of 57.58 months (4.14-170.05). When the patients were analyzed based on mortality the NLR and SII values were statistically significantly increased in the dead group (2.71 (1.22-4.1 ) vs. 1.7 (0.16-5.1); p=0.02; and 677.8 (215-1322) vs. 294.6 (69.49-799.1), respectively; p=0.012). Analysis of the receiver operating curve found that 328.49 is the ideal cutoff value for SII to predict mortality with a sensitivity of 83% and a specificity of 68% (area under the receiver operating characteristic curve = 0.814 (95% confidence interval: 0.671-0.956), p=0.005 ). Analyzing the influence of risk factors on survival using Cox regression analysis, SII was discovered as a significant predictor of survival in the study (HR =1.001, 95% CI =1-1.20; p=0.049). CONCLUSION SII may be used to predict the overall survival of NB patients.
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Affiliation(s)
| | - Zerrin Özçelik
- Pediatric Surgery, Adana City Training Hospital, Adana, TUR
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8
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Makino T, Izumi K, Iwamoto H, Kadomoto S, Kadono Y, Mizokami A. Comparison of the Prognostic Value of Inflammatory and Nutritional Indices in Nonmetastatic Renal Cell Carcinoma. Biomedicines 2023; 11:biomedicines11020533. [PMID: 36831069 PMCID: PMC9953714 DOI: 10.3390/biomedicines11020533] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
Several markers that reflect inflammation and nutritional status have been associated with oncological outcomes in many tumors. This study aimed to describe the impact of pretreatment inflammatory and nutritional indices on the oncological outcomes in nonmetastatic renal cell carcinoma (RCC). A total of 213 Japanese patients with nonmetastatic RCC at Kanazawa University Hospital between October 2007 and December 2018 were included. The inflammatory and nutritional indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI), were retrospectively analyzed. The optimal cutoffs for NLR, PLR, CAR, PNI, and GNRI were 2.18, 153.7, 0.025, 48.4, and 98, respectively. According to Kaplan-Meier curves, elevated NLR, PLR, CAR, and GNRI correlated with increased metastasis, while NLR and PNI correlated with worse overall survival (OS). In multivariate analysis, high CAR was an independent poor risk factor for metastasis (hazard ratio (HR), 3.08; 95% confidence interval (CI), 1.24-7.67; p = 0.016). Furthermore, high NLR showed an independent prognostic factor for worse OS (HR, 3.96; 95% CI, 1.01-15.59; p = 0.049). The pretreatment inflammatory and nutritional indices such as NLR and CAR might be promising prognostic factors for nonmetastatic RCC.
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Affiliation(s)
- Tomoyuki Makino
- Correspondence: ; Tel.: +81-76-265-2393; Fax: +81-76-234-4263
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9
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Baseline and Dynamic Changes in Hemoglobin Levels Predict Treatment Response and Prognosis in Metastatic Renal Cell Carcinoma: A Multicenter Retrospective Study. Clin Genitourin Cancer 2023:S1558-7673(23)00035-6. [PMID: 36922286 DOI: 10.1016/j.clgc.2023.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Clinical markers of response in metastatic renal cell carcinoma (mRCC) are lacking. Low hemoglobin (Hb) is associated with poor outcomes in the IMDC risk score. This study evaluates the role of Hb as a marker of treatment outcomes in mRCC. PATIENTS AND METHODS This multicenter retrospective study evaluated 276 patients with mRCC treated with frontline immune checkpoint inhibitor (ICI) therapy, ICI and vascular endothelial growth factor (VEGF) inhibitor (VEGFI) combinations (ICI/VEGFI), or VEGFI monotherapy between 2014 and 2021. Hb levels at baseline, week 6 and 12 and at disease progression or death were recorded. Patients were categorized as responders (CR+PR) or nonresponders (SD+PD) using cross-sectional imaging at week 12. The association between baseline and dynamic changes in Hb and oncological outcomes was assessed. RESULTS Thirty-seven percent, 40% and 22% of patients received ICIs, ICI/VEGFI and VEGFI respectively. In patients receiving ICIs, there was a significant increase in Hb amongst responders from baseline to week 12 (P= .02). Amongst patients receiving ICI/VEGFI, there was an increase in Hb from baseline to week 12 which was greater in responders (P< .001). In patients receiving VEGFI monotherapy, responders had a higher Hb at baseline (P= .01), week 6 (P= .04), and week 12 (P= .003). An increase in Hb was a significant independent predictor of progression-free survival amongst patients receiving ICIs (HR 0.40, 95%CI, 0.19-0.83, P= .009). CONCLUSION Baseline and dynamic changes in Hb are associated with first-line treatment outcomes in patients with mRCC and represent a pragmatic early serological marker.
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10
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Sadri S, Cavusoglu G, Tunay B. Do neutrophil-lymphocyte ratio and platelet-lymphocyte ratio have a role in determining mortality in intensive care patients undergoing plasmapheresis? Single-center experience. Ther Apher Dial 2023; 27:146-151. [PMID: 35730341 DOI: 10.1111/1744-9987.13900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/28/2022] [Accepted: 06/20/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Plasmapheresis is a frequently used procedure that removes the pathogenic components from circulation. We aimed to evaluate the relationship between plasmapheresis, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mortality in the intensive care unit (ICU) between 2014 and 2021. METHODS Forty-nine patients (27 females and 22 males) were included. Demographic characteristics, laboratory values of the day of admittance to the ICU, APACHE II scores, and length of stay were recorded. RESULTS The mean age was 52.73 ± 16.93. APACHE II value (p = 0.003; p < 0.01), NLR ratio (p = 0.001; p < 0.01) and PLR ratio (p = 0.001; p < 0.01) of the surviving group were lower than those of the deceased group, which was statistically significant. CONCLUSION As high PLR and NLR levels suggest increased mortality in the ICU population, attention should be paid for increased NLR and PLR when plasmapheresis is decided on in the ICU.
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Affiliation(s)
- Sevil Sadri
- Department of Internal Medicine, Haematology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Gunes Cavusoglu
- Department of Internal Medicine, Haematology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Burcu Tunay
- Department of Anesthesiology and Reanimation, Istanbul Medipol University School of Medicine, Istanbul, Turkey
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11
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Li H, Zhang X, Zhang Q, Zhang Q, Zhu X, Xie T, Wang S. The relationship between the monocyte-to-lymphocyte ratio and osteoporosis in postmenopausal females with T2DM: A retrospective study in Chinese population. Front Endocrinol (Lausanne) 2023; 14:1112534. [PMID: 36891058 PMCID: PMC9987332 DOI: 10.3389/fendo.2023.1112534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/30/2023] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION The risk of fragility fractures is increased in patients with type 2 diabetes mellitus (T2DM). Many reports indicate that inflammatory and immune responses are associated with osteoporosis and osteopenia. The monocyte-to-lymphocyte ratio (MLR) is a novel potential marker of inflammatory and immune responses. The present study evaluated the associations between the MLR and osteoporosis in postmenopausal females with T2DM. METHODS Data were obtained from 281 T2MD postmenopausal females, and divided into three groups: Osteoporosis group, osteopenia group and normal BMD group. RESULT Data analyses revealed that the MLR was significantly lower in T2MD postmenopausal females with osteoporosis than in those with osteopenia and normal BMD. Logistic regression showed that the MLR was an independent protective factor for osteoporosis in postmenopausal females with T2DM (odds ratio [OR]: 0.015, 95% confidence interval [CI]: 0.000-0.772). Based on the receiver operating characteristic (ROC) curve, the MLR for diagnosing osteoporosis in postmenopausal females with T2DM was projected to be 0.1019, an area under the curve of 0.761 (95% CI: 0.685-0.838), a sensitivity of 74.8% and a specificity of 25.9%. CONCLUSIONS The MLR have a high efficacy in diagnosis for osteoporosis in postmenopausal females with T2DM. MLR have the potential to be used as diagnosis marker for osteoporosis in postmenopausal females with T2DM.
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Affiliation(s)
- Hailin Li
- Department of General Family Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xinqi Zhang
- Department of General Family Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qi Zhang
- Department of General Family Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qiong Zhang
- Department of General Family Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xueying Zhu
- Department of General Family Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tuxiu Xie
- Department of General Family Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuo Wang
- Department of Endocrinology & Metabolism, Renmin Hospital of Wuhan University, Wuhan, China
- *Correspondence: Shuo Wang,
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12
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Tommasi C, Scartabellati G, Giannarelli D, Giorgi UD, Brighi N, Fornarini G, Rebuzzi SE, Puglisi S, Caffo O, Kinspergher S, Mennitto A, Cattrini C, Santoni M, Verzoni E, Rametta A, Stellato M, Malgeri A, Roviello G, Brunelli M, Buti S. The role of mean corpuscular volume and red cell distribution width in patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors: the MARECAP retrospective study. Ther Adv Urol 2023; 15:17562872231187216. [PMID: 37492625 PMCID: PMC10363886 DOI: 10.1177/17562872231187216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 06/19/2023] [Indexed: 07/27/2023] Open
Abstract
Background Tyrosine-kinase inhibitors (TKIs) and immunotherapy represent the backbone treatment for metastatic renal cell carcinoma (mRCC) patients. The aim of the present study was to describe mean corpuscular volume (MCV) and red cell distribution width (RDW) in mRCC patients treated with pazopanib or cabozantinib, and to explore their potential impact on oncological outcomes. Materials and methods We conducted a multicenter retrospective observational study in mRCC patients treated with pazopanib or cabozantinib between January 2012 and December 2020 in nine Italian centers. Descriptive statistics, univariate, and multivariate analyses were performed. Objectives The primary endpoints were the incidence and trend over time of anemia, macrocytosis (elevated MCV), and anisocytosis (elevated RDW). The secondary endpoints were the correlations of MCV and RDW with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results A total of 301 patients were enrolled; mean Hb value was 12.5 g/dl, a mean increase of 1 g/dl was observed at day 15 and maintained at 3 months. Most patients had baseline macrocytosis (MCV levels > 87 fl), with a significant mean increase after 3 months of treatment. At univariate analysis patients with macrocytosis had better ORR, longer PFS, and OS. About one third of patients had baseline anisocytosis (RDW > 16%), with a significant mean increase after 3 months of treatment. At univariate analysis, patients with RDW values ⩽ 16% had higher ORR, longer PFS, and OS. At multivariate analysis, baseline macrocytosis was significantly associated with better PFS in patients treated with pazopanib and baseline anisocytosis with shorter OS in all patients. Conclusions mRCC patients treated with pazopanib or cabozantinib may have baseline macrocytosis and anisocytosis. A significant increase of Hb, MCV, and RDW after TKIs start was observed. Baseline macrocytosis is positively correlated with PFS in patients treated with pazopanib and baseline anisocytosis affects survival of patients treated with TKIs.
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Affiliation(s)
| | | | - Diana Giannarelli
- Facility Epidemiology and Biostatistic, G-Step, Fondazione Policlinico Universitario A. Gemelli, Scientific Direction, IRCCS, Rome, Italy
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Nicole Brighi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Savona, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genova, Italy
| | - Silvia Puglisi
- Medical Oncology Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy
| | | | - Alessia Mennitto
- Division of Oncology, University Hospital ‘Maggiore della Carità’, Novara, Italy
| | - Carlo Cattrini
- Division of Oncology, University Hospital ‘Maggiore della Carità’, Novara, Italy
| | | | - Elena Verzoni
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Alessandro Rametta
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Marco Stellato
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Andrea Malgeri
- Department of Medical Oncology, Università Campus Bio-Medico di Roma, Rome, Italy
| | | | - Matteo Brunelli
- Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Verona, Italy
| | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC), Parma, Italy
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13
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Wang Z, Qin Y, Chai X, Lu L, Xue P, Lu R, Miao C, Ma H, Hu X, Yao J. Systemic Inflammatory Biomarkers Predict Survival of Patients Treated With Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma. Cancer Control 2023; 30:10732748231197511. [PMID: 37673428 PMCID: PMC10486224 DOI: 10.1177/10732748231197511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/09/2023] [Accepted: 07/25/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE We aimed to retrospectively investigate whether the neutrophil to lymphocyte ratio (NLR) and the monocyte to lymphocyte ratio (MLR) can predict the prognosis of patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib or sorafenib. METHODS We retrospectively identified 210 patients with mRCC treated with sunitinib or sorafenib from 2007 to 2017 at Fudan University- and Hexi University-affiliated hospitals. Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method. Multivariate regression analysis was used to evaluate predictors of PFS and OS. RESULTS Low NLR (<2.85) and MLR (<.30) were strongly associated with increased PFS and OS. Multivariable analyses verified that the NLR and MLR were both independent prognostic factors. Additionally, the NLR was negatively correlated with CD8+ and CD4+ T-cell infiltration in tumors. CONCLUSION In patients with mRCC treated with sunitinib and sorafenib, an NLR <2.85 and MLR <.30 was associated with superior PFS and OS, which may be related to the reduced lymphocytic infiltration of tumors.
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Affiliation(s)
- Zhaojuan Wang
- Department of Pharmacy, Hexi University Affiliated Zhangye People’s Hospital, Zhangye, China
| | - Yujie Qin
- Department of Endoscopy Center, Hexi University Affiliated Zhangye People’s Hospital, Zhangye, China
| | - Xuxia Chai
- Department of Laboratory, Hexi University Affiliated Zhangye People’s Hospital, Zhangye, China
| | - Lina Lu
- Hexi University School of Medicine, Zhangye, China
| | - Ping Xue
- Hexi University School of Medicine, Zhangye, China
| | - Runrun Lu
- Hexi University School of Medicine, Zhangye, China
| | | | - Haimei Ma
- Hexi University School of Medicine, Zhangye, China
| | - Xiaoyi Hu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiaxi Yao
- Department of Urology, Hexi University Affiliated Zhangye People’s Hospital, Zhangye, China
- Institute of Urology, Hexi University, Zhangye, China
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Greco F, Beomonte Zobel B, Mallio CA. Decreased cross-sectional muscle area in male patients with clear cell renal cell carcinoma and peritumoral collateral vessels. World J Radiol 2022; 14:82-90. [PMID: 35646290 PMCID: PMC9124980 DOI: 10.4329/wjr.v14.i4.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/15/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sarcopenia is the loss of skeletal muscle mass (SMM) and is a sign of cancer cachexia. Patients with advanced renal cell carcinoma (RCC) may show cachexia.
AIM To evaluate the amount of SMM in male clear cell RCC (ccRCC) patients with and without collateral vessels.
METHODS In this study, we included a total of 124 male Caucasian patients divided into two groups: ccRCCa group without collateral vessels (n = 54) and ccRCCp group with collateral vessels (n = 70). Total abdominal muscle area (TAMA) was measured in both groups using a computed tomography imaging-based approach. TAMA measures were also corrected for age in order to rule out age-related effects.
RESULTS There was a statistically significant difference between the two groups in terms of TAMA (P < 0.05) driven by a reduction in patients with peritumoral collateral vessels. The result was confirmed by repeating the analysis with values corrected for age (P < 0.05), indicating no age effect on our findings.
CONCLUSION This study showed a decreased TAMA in ccRCC patients with peritumoral collateral vessels. The presence of peritumoral collateral vessels adjacent to ccRCC might be a fine diagnostic clue to sarcopenia.
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Affiliation(s)
- Federico Greco
- Unità Operativa Complessa Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Lecce 73100, Italy
| | - Bruno Beomonte Zobel
- Unit of Diagnostic Imaging, Università Campus Bio-Medico di Roma, Rome 00128, Italy
| | - Carlo Augusto Mallio
- Unit of Diagnostic Imaging, Università Campus Bio-Medico di Roma, Rome 00128, Italy
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15
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Rebuzzi SE, Cerbone L, Signori A, Santoni M, Murianni V, De Giorgi U, Procopio G, Porta C, Milella M, Basso U, Massari F, Maruzzo M, Iacovelli R, Battelli N, Carmisciano L, Banna GL, Buti S, Fornarini G. Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib. Ther Adv Med Oncol 2022; 14:17588359221079580. [PMID: 35237353 PMCID: PMC8883304 DOI: 10.1177/17588359221079580] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/21/2022] [Indexed: 12/25/2022] Open
Abstract
Background: The addition of neutrophil-to-lymphocyte ratio (NLR) and bone metastases to the International Metastatic RCC Database Consortium (IMDC) score (by the Meet-URO score) has been shown to better stratify pretreated metastatic renal cell carcinoma (mRCC) patients receiving nivolumab. This study aimed to validate the Meet-URO score in patients receiving cabozantinib to assess its predictivity and prognostic role. Methods: A multicenter retrospective analysis evaluated mRCC patients receiving ⩾second-line cabozantinib. NLR, IMDC score and bone metastases were assessed before the start of cabozantinib. The primary endpoint was overall survival (OS). Harrell’s c-index was calculated to compare the accuracy of the prediction of the two scores. Results: Overall, 174 mRCC patients received cabozantinib as second and third line (51.7% and 48.3%, respectively) with a median follow-up of 6.8 months. A shorter median overall survival (mOS) was observed for the IMDC poor-risk group, NLR ⩾3.2 and the presence of bone metastases, while the IMDC intermediate-risk group had a similar mOS to the favourable-risk one. Applying the Meet-URO score, three risk groups were identified: group 1 (55.2% of patients) with a score of 0–3, group 2 (38.5%) with a score of 4–8 and group 3 (6.3%) with a score of 9. Compared to group 1 (mOS: 39.4 months), a statistically significant worse mOS was observed in group 2 (11.2 months) and group 3 (3.2 months) patients, respectively. The Meet-URO c-index score was 0.640, showing a higher discriminative ability than the IMDC score (c-index: 0.568). Conclusion: This analysis showed that the Meet-URO score provides a more accurate prognostic stratification than the IMDC score in mRCC patients treated with ⩾second-line cabozantinib besides nivolumab. Moreover, it is an easy-to-use tool with no additional costs for clinical practice (web-calculator is available at: https://proviso.shinyapps.io/Meet-URO15_score/). Future investigations will include the application of the Meet-URO score to the first-line immunotherapy-based combination therapies.
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Affiliation(s)
- Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Via Genova, 30, 17100 Savona, Italy
- Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genova, Italy
| | | | - Alessio Signori
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genova, Genova, Italy
| | | | - Veronica Murianni
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy
| | - Giuseppe Procopio
- SS Oncologia Medica Genitourinaria, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Camillo Porta
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
- Division of Medical Oncology, A.O.U. Consorziale Policlinico di Bari, Bari, Italy
| | - Michele Milella
- Medical Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Umberto Basso
- Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Maruzzo
- Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy
| | - Roberto Iacovelli
- Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Luca Carmisciano
- Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genova, Genova, Italy
| | | | - Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Giuseppe Fornarini
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy
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Mao W, Wang K, Wu Y, Ni J, Zhang H, Wang Y, Wu Z, Liu R, Geng J, Chen S, Chen M. Prognostic Significance of Modified Advanced Lung Cancer Inflammation Index in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy: A Multi-Institutional, Propensity Score Matching Cohort Study. Front Nutr 2022; 8:781647. [PMID: 35127784 PMCID: PMC8811296 DOI: 10.3389/fnut.2021.781647] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background We conducted a multi-institutional clinical study to assess the prognostic value of the advanced lung cancer inflammatory index (ALI) and modified ALI (mALI) in patients with renal cell carcinoma (RCC). Methods We collected 440 patients who underwent laparoscopic nephrectomy at three centers from 2014 to 2019. ALI was defined as body mass index (BMI) × serum albumin (ALB)/neutrophil-to-lymphocyte ratio (NLR) and mALI as L3 muscle index × ALB/NLR. Kaplan-Meier curves, receiver operating characteristic (ROC) curves and Cox survival analysis were used to assess the effect of ALI and mALI on overall survival (OS). In addition, we performed 1:1 propensity score matching (PSM) for the high mALI and low mALI groups to further explore the impact of mALI on survival in RCC patients. Results The optimal cut-off values for ALI and mALI were 40.6 and 83.0, respectively. Based on the cut-off values, we divided the patients into high ALI and low ALI groups, high mALI and low mALI groups. ALI and mALI were significantly associated with the AJCC stage, Fuhrman grade, T stage, and M stage. Low ALI (p = 0.002) or low mALI (p < 0.001) was associated with poorer prognosis. ROC curves showed that mALI was a better predictor of OS than ALI. Multivariate Cox regression analysis showed that low mALI (aHR = 2.22; 95% CI 1.19–4.13, p = 0.012) was an independent risk factor for OS in RCC patients who underwent nephrectomy, while ALI (aHR = 1.40; 95% CI 0.73–2.66, p = 0.309) was not significantly associated. Furthermore, after PSM analysis, we found that mALI remained an independent risk factor for OS (aHR = 2.88; 95% CI 1.33–6.26, p = 0.007) in patients with RCC. Conclusions For RCC patients undergoing laparoscopic nephrectomy, low ALI and low mALI were associated with poor prognosis, and preoperative mALI can be used as a potential independent prognostic indicator for RCC patients.
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Affiliation(s)
- Weipu Mao
- Department of Urology, Shidong Hospital of Yangpu District, Shanghai, China
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Keyi Wang
- Department of Urology, Shidong Hospital of Yangpu District, Shanghai, China
| | - Yuan Wu
- Department of Urology, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, China
| | - Jinliang Ni
- Department of Urology, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Houliang Zhang
- Department of Urology, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yidi Wang
- Department of Urology, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Zonglin Wu
- Department of Urology, Shidong Hospital of Yangpu District, Shanghai, China
| | - Ruiji Liu
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Jiang Geng
- Department of Urology, School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
- Jiang Geng
| | - Shuqiu Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
- Shuqiu Chen
| | - Ming Chen
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
- *Correspondence: Ming Chen
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Chen X, Wang Q, Li C. A Retrospective Analysis of Hematologic Parameters in Patients with Early Diabetic Kidney Disease. Clin Appl Thromb Hemost 2022; 28:10760296221083681. [PMID: 35249376 PMCID: PMC8905051 DOI: 10.1177/10760296221083681] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To retrospectively analyze the hematologic parameters in patients with early Diabetic Kidney Disease (DKD) to define potential biomarkers that can be used to predict early DKD. METHODS 134 diabetic patients without nephropathy and 49 patients with early DKD were enrolled for this study and the hematologic parameters were retrospectively analyzed. Paired comparison was conducted by T-test and the predicting value of any statistically different parameter was tested using the Receiver Operating Characteristic curve (ROC) analysis model. RESULTS The number of Neutrophil (N) was higher (P <0.001) while monocyte (M) was lower (P <0.01) in the early DKD group than that of DM group without nephropathy. In addition, neutrophil to lymphocyte ratio (NLR) was higher while platelet to lymphocyte ratio (PLR) was significantly lower in the early DKD group(P <0.001). Results from ROC curve analysis showed the sensitivity and specificity of PLR to predict early DKD were 83.7% and 82.6%, respectively. CONCLUSIONS PLR may be a potential hematologic parameter that can be used to predict early DKD.
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Affiliation(s)
- Xu Chen
- Department of Laboratory Medicine, Jingzhou Hospital, Yangtze University, Jingzhou, China
| | - Qinghua Wang
- Department of Emergency, The Traditional Chinese Medicine Hospital of Wenjiang District, Chengdu, China
| | - Chengbin Li
- Department of Laboratory Medicine, Jingzhou Hospital, Yangtze University, Jingzhou, China
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18
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Liu Y, Wang X, Wang L, Chen W, Liu W, Ye T, Hong J, Zhu H, Shen F. Platelet-to-Lymphocyte Ratio Predicts the Presence of Diabetic Neurogenic Bladder. Diabetes Metab Syndr Obes 2022; 15:7-13. [PMID: 35018105 PMCID: PMC8742579 DOI: 10.2147/dmso.s335957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/20/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Diabetic neurogenic bladder (DNB) has been widely recognized in recent years. It is common in patients with long-term diabetes and may also lead to many severe complications. Although there has been widespread evidence that inflammation is involved in the development of some diabetic complications, there is little evidence that this can also occur in the bladder. In recent years, platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have been viewed as potential novel markers of inflammatory responses. This study was designed to evaluate the relationship between the presence of DNB and the PLR and NLR. PATIENTS AND METHODS A total of 371 cases of T2DM patients were included in this retrospective study. Patients were divided into two groups, with 115 diabetic subjects diagnosed with diabetic neurogenic bladder and 256 control subjects without DNB. The independent predictors of DNB were analyzed using logistic regression. RESULTS Compared with patients without DNB, the mean PLR and NLR were significantly higher in those with DNB (p < 0.001). Based on the logistic regression, PLR was found to be an independent risk factor for DNB (odds ratio [OR]: 1.408, 95% confidence interval [CI]: 1.248-1.617). From the receiver operating characteristic (ROC) curve, using PLR as indicative of DNB was expected to be 101.1949, and it generated a sensitivity and specificity value of 89.6% and 23.4%, respectively. The area under the curve (AUC) was also found to be 0.899 (95% CI: 0.865-0.932). CONCLUSION In our study, PLR and NLR were significantly higher for patients with DNB. The PLR was found to be a risk factor in the presence of DNB after correcting for possible confounding factors. Considering the severe complications associated with DNB, patients with elevated PLR should be seriously cared for in clinics.
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Affiliation(s)
- Yiying Liu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Xin Wang
- Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, People’s Republic of China
| | - Linying Wang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Wenwen Chen
- Department of Senile Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Wenyue Liu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Tingting Ye
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Jing Hong
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Hong Zhu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Feixia Shen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China
- Correspondence: Feixia Shen Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China Email
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19
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Longhi R, Santos ASEADC, López-Yerena A, Rodrigues APS, de Oliveira C, Silveira EA. The Effectiveness of Extra Virgin Olive Oil and the Traditional Brazilian Diet in Reducing the Inflammatory Profile of Individuals with Severe Obesity: A Randomized Clinical Trial. Nutrients 2021; 13:4139. [PMID: 34836393 PMCID: PMC8624522 DOI: 10.3390/nu13114139] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 12/26/2022] Open
Abstract
We analyzed the effectiveness of two nutritional interventions alone and together, EVOO and the DieTBra, on the inflammatory profile of severely obese individuals. This study was an RCT with 149 individuals aged from 18 to 65 years, with a body mass index ≥ 35 kg/m2, randomized into three intervention groups: (1) 52 mL/day of EVOO (n = 50); (2) DieTBra (n = 49); and (3) DieTBra plus 52 mL/day of EVOO (DieTBra + EVOO, n = 50). The primary outcomes we measured were the-neutrophil-to-lymphocyte ratio (NLR) and the secondary outcomes we measured were the lymphocyte-to-monocyte ratio (LMR); leukocytes; and C reactive protein (CRP). After 12 weeks of intervention, DieTBra + EVOO significantly reduced the total leucocytes (p = 0.037) and LMR (p = 0.008). No statistically significant differences were found for the NLR in neither the intra-group and inter-group analyses, although a slight reduction was found in the DieTBra group (-0.22 ± 1.87). We observed reductions in the total leukocytes and LMR in the three groups, though without statistical difference between groups. In conclusion, nutritional intervention with DietBra + EVOO promotes a significant reduction in inflammatory biomarkers, namely leukocytes and LMR. CRP was reduced in EVOO and DieTBra groups and NLR reduced in the DieTBra group. This study was registered at ClinicalTrials.gov under NCT02463435.
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Affiliation(s)
- Rafael Longhi
- Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte 30130-100, Brazil;
| | - Annelisa Silva e Alves de Carvalho Santos
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Rua 235 c/1ª s/n, Setor Universitário, Goiânia 74650-050, Brazil; (A.S.e.A.d.C.S.); (A.P.S.R.)
| | - Anallely López-Yerena
- Department of Nutrition, Food Science and Gastronomy, XIA, Faculty of Pharmacy and Food Sciences, Institute of Nutrition and Food Safety (INSA-UB), University of Barcelona, 08028 Barcelona, Spain;
| | - Ana Paula Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Rua 235 c/1ª s/n, Setor Universitário, Goiânia 74650-050, Brazil; (A.S.e.A.d.C.S.); (A.P.S.R.)
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, London University College, London WC1E 6BT, UK;
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia, Rua 235 c/1ª s/n, Setor Universitário, Goiânia 74650-050, Brazil; (A.S.e.A.d.C.S.); (A.P.S.R.)
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, London University College, London WC1E 6BT, UK;
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20
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O'Brian D, Prunty M, Hill A, Shoag J. The Role of C-Reactive Protein in Kidney, Bladder, and Prostate Cancers. Front Immunol 2021; 12:721989. [PMID: 34512646 PMCID: PMC8429489 DOI: 10.3389/fimmu.2021.721989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
C-Reactive Protein (CRP) is associated with diverse outcomes in patients with, or suspected to have, genitourinary malignancies. CRP levels have been shown to be associated with the probability of a prostate cancer diagnosis in patients with elevated PSA, the probability of biochemical recurrence following definitive treatment for localized prostate cancer, and decreased overall survival for patients with advanced disease. In patients with bladder and kidney cancers, CRP levels have been associated with disease progression, stage, and cancer-specific survival. Despite the abundance of correlative studies, the relationship between CRP levels and genitourinary cancer pathogenesis is not clearly understood. Here, we review the evidence for CRP as a biomarker in genitourinary (GU) cancers, with specific focus on potential clinical applications.
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Affiliation(s)
- Daniel O'Brian
- Northwestern University, Feinberg School of Medicine, Chicago, IL, United States
| | - Megan Prunty
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.,Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Alexander Hill
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Jonathan Shoag
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States.,Case Western Reserve University School of Medicine, Cleveland, OH, United States
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21
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Yılmaz H, Yılmaz A, Demirağ G. Prognostic significance of hemoglobin-to-red cell distribution width ratio in patients with metastatic renal cancer. Future Oncol 2021; 17:3853-3864. [PMID: 34382414 DOI: 10.2217/fon-2021-0040] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of the current research was to investigate the prognostic significance of pretreatment hemoglobin-to-red cell distribution width ratio (HRR) in patients with renal cell carcinoma (RCC). The neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, lymphocyte-to-monocyte ratio (LMR) and HRR were analyzed retrospectively to assess their prognostic value using Kaplan-Meier curves and Cox regression analysis in 198 patients with RCC. High HRR (0.72) and high LMR (2.43) were found to be associated with longer progression-free survival and overall survival. A multivariate analysis identified International Metastatic Renal Cell Carcinoma Database Consortium prognostic score, tumor stage, node stage, LMR and HRR as independent prognostic factors for progression-free survival, as well as International Metastatic Renal Cell Carcinoma Database Consortium score, neutrophil-to-lymphocyte ratio and HRR for overall survival. HRR is a an independent prognostic parameter predicting the progression and survival of patients with RCC.
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Affiliation(s)
- Hatice Yılmaz
- Department of Medical Oncology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Ali Yılmaz
- Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Güzin Demirağ
- Department of Medical Oncology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
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22
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Bolzacchini E, Giordano M, Bertù L, Bregni M, Nigro O, Galli L, Antonuzzo A, Artale S, Barzaghi S, Danova M, Torchio M, Pinotti G, Dentali F. Prognostic role of hematologic parameters of metastatic renal cell carcinoma treated with sunitinib. TUMORI JOURNAL 2021; 108:502-509. [PMID: 34296630 DOI: 10.1177/03008916211033905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hemochrome parameters at the diagnosis of metastatic renal cell carcinoma (mRCC) and the development of macrocytosis during sunitinib therapy are considered prognostic. OBJECTIVE To evaluate the prognostic role of hematologic parameters and macrocytosis in mRCC treated with sunitinib. METHODS We analyzed clinical data of 100 patients with mRCC treated with sunitinib as first-line therapy in a retrospective multicenter study. We calculated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) at baseline and erythrocyte mean corpuscular volume (MCV) during therapy. We considered the following cutoffs: NLR >3, PLR >150, LMR <3, and MCV >100 fl. Clinical data histology, prior nephrectomy, Fuhrman grading, metastatic sites, Memorial Sloan-Kettering Cancer Center score, and Heng score were collected. Overall survival (OS) and progression-free survival (PFS) were calculated. Univariate and multivariate analysis using Cox regression model with time-dependent (macrocytosis) covariate were applied. RESULTS At the univariate analysis, low LMR was associated with shorter PFS and OS (p = 0.02 and p = 0.06, respectively). High PLR was associated with worse PFS (p = 0.005); median OS was 23 vs 28 months (p = 0.13). At the multivariate analysis, poor risk (Heng score), low LMR, and high PLR were associated with shorter PFS (hazard ratio 7.1, 1.5, and 2, respectively); poor PS and poor risk (Heng score) were related to worst OS. Macrocytosis was observed in 26 patients and was not prognostic of survival. CONCLUSIONS In our cohort of patients with mRCC treated with sunitinib, low LMR (>3) and high PLR (>150) were associated with shorter PFS. Macrocytosis was not prognostic.
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Affiliation(s)
- Elena Bolzacchini
- U.O. Oncologia, Ospedale Sant'Anna, ASST-Lariana, Como, Italy.,Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria di Varese, Varese, Italy
| | - Monica Giordano
- U.O. Oncologia, Ospedale Sant'Anna, ASST-Lariana, Como, Italy
| | - Lorenza Bertù
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria di Varese, Varese, Italy
| | - Marco Bregni
- U.O. Oncologia,Ospedale di Circolo di Busto Arsizio, ASST della Valle Olona, Busto Arsizio, Italy
| | - Olga Nigro
- U.O. Oncologia,Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | - Luca Galli
- U.O. Oncologia, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Andrea Antonuzzo
- U.O. Oncologia, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Salvatore Artale
- U.O. Oncologia, Ospedale S.Antonio Abate, ASST della Valle Olona, Gallarate, Italy
| | - Sabrina Barzaghi
- U.O. Oncologia, Ospedale S.Antonio Abate, ASST della Valle Olona, Gallarate, Italy
| | - Marco Danova
- U.O. Medicina Interna od Indirizzo Oncologico, Ospedale Civile, ASST di Pavia, Vigevano, Italy
| | - Martina Torchio
- U.O. Medicina Interna od Indirizzo Oncologico, Ospedale Civile, ASST di Pavia, Vigevano, Italy
| | - Graziella Pinotti
- U.O. Oncologia,Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | - Francesco Dentali
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria di Varese, Varese, Italy
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23
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Hwang I, Park I, Yoon SK, Lee JL. Clinical course of patients with renal cell carcinoma or urothelial carcinoma who had stable disease as an initial response to a PD-1 or PD-L1 inhibitor. Asia Pac J Clin Oncol 2021; 18:371-377. [PMID: 34219393 DOI: 10.1111/ajco.13601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/06/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND About 17%-34% of patients with non-prostatic genitourinary (GU) cancer had stable disease (SD) as their best response to programmed cell death protein 1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors. However, most efficacy studies of PD-1/PD-L1 inhibitors are focused on the response and its durability. Little is known about patients' clinical outcomes with SD as their initial response to PD-1/PD-L1 inhibitors. METHODS We retrospectively reviewed the clinical outcomes of patients with renal cell carcinoma (RCC) (n = 102) and urothelial carcinoma (UC) (n = 101) treated with PD-1/PD-L1 inhibitors. The duration of SD (DoSD) was calculated for patients who had SD as their best response and was defined from the time of SD to radiologically confirmed progressive disease (PD) or death. RESULTS Fifty-five patients (27.1%) had SD as the initial response. Among them, 10 patients (18.2%) achieved a response on subsequent assessments. With a median follow-up duration of 15.2 months, the median DoSD was 8.5 months (range: 3.2-13.8), which was significantly different according to the disease; 9.4 months in RCC and 2.3 months in UC (p = 0.03). If the disease did not progress in 4 months (long SD subgroup), the DoSD (11.0 months) was comparable to the duration of response (12.9 months) in patients who achieved a complete or partial response to PD-1/PD-L1 inhibitors. In addition to the cancer type, the clinical factors associated with short DoSD were liver metastases (p = 0.003), neutrophil-lymphocyte ratio (NLR) > 4.0 (p = 0.001), and platelet-lymphocyte ratio (PLR) > 194 (p = 0.003). CONCLUSION For RCC patients with SD to PD-1/PD-L1 inhibitors, if there are no liver metastases and NLR/PLR is below the certain level, they would have similar duration of disease control and survival benefit as those who achieve the response.
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Affiliation(s)
- Inhwan Hwang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.,Department of Oncology, Yuseong Sun Medical Center, Daejeon, South Korea
| | - Inkeun Park
- Division of Medical Oncology, Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Shin-Kyo Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Lyun Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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24
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25
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Wu M, Yang S, Feng X, Li C, Yu F, Dong J. Prognostic value of the postoperative neutrophil-lymphocyte ratio in solid tumors: A meta-analysis. PLoS One 2021; 16:e0250091. [PMID: 33872342 PMCID: PMC8055017 DOI: 10.1371/journal.pone.0250091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/30/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Numerous studies have demonstrated that a variety of systemic inflammatory markers were associated with the survival of different tumors. However, the association between elevated postoperative neutrophil-lymphocyte ratio (postNLR) and long-term outcomes, including overall survival (OS), disease-free survival (DFS), in patients with solid tumors remains controversial. A systematic review was conducted to explore the association between the postNLR and long-term outcomes in solid tumors. MATERIALS AND METHODS Relevant literature was identified using PubMed, Embase, Web of Science, and the Cochrane Library from the initiation of the databases to October 2020. Data were extracted from included studies reporting hazard ratio (HR) and 95% confidence intervals (CI), and were pooled using generic inverse-variance and random-effects modeling. 25 studies reporting on7539 patients were included in the analysis. RESULTS Elevated postNLR was associated with poor OS (HR 1.87, 95% CI = 1.53-2.28; P < 0.00001), and worse DFS (HR 1.69, 95% CI = 1.28-2.22; P = 0.0002). Subgroup analyses showed that the trend of the pooled HR for most of the subgroups was not changed, and the heterogeneity of the same tumor type was not obvious. However, there was no correlation between high postNLR obtained within 7days and poor DFS (n = 3, HR 1.25, 95CI% = 0.54-2.88; P = 0.60). CONCLUSIONS Elevated postNLR might be a readily available and inexpensive biomarker for long-term outcomes in solid tumors. Multicenter and prospective studies are needed to explore the impact of the postNLR on the prognosis of solid tumors.
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Affiliation(s)
- Meilong Wu
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Shizhong Yang
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Xiaobin Feng
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Chengquan Li
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Institute for Precision Healthcare, Tsinghua University, Haidian District, Beijing, China
| | - Fei Yu
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
| | - Jiahong Dong
- School of Clinical Medicine, Tsinghua University, Haidian District, Beijing, China
- Hepato-pancreato-biliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Changping District, Beijing, China
- Institute for Precision Healthcare, Tsinghua University, Haidian District, Beijing, China
- * E-mail:
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26
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Liu H, Sun S, Wang G, Lu M, Zhang X, Wei X, Gao X, Huang C, Li Z, Zheng J, Zhang Q. Tyrosine Kinase Inhibitor Cabozantinib Inhibits Murine Renal Cancer by Activating Innate and Adaptive Immunity. Front Oncol 2021; 11:663517. [PMID: 33954115 PMCID: PMC8089383 DOI: 10.3389/fonc.2021.663517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/29/2021] [Indexed: 12/20/2022] Open
Abstract
Background Advanced renal cell carcinoma (RCC) has a very dismal prognosis. Cabozantinib, a tyrosine kinase inhibitor, has been approved for the treatment of advanced RCC. However, the impact of cabozantinib on the immune microenvironment of RCC remains poorly understood. Methods Kaplan-Meier survival curves were constructed to examine the correlation between intratumor infiltration of neutrophils and patient prognosis in RCC. Infiltration and effector function of neutrophils and T cells in response to cabozantinib treatment were investigated in a murine RCC model. Results A retrospective study of 307 RCC patients indicated that neutrophils were recruited into tumor tissues, and increased neutrophil infiltration was associated with improved clinical outcomes. In a murine model of RCC, cabozantinib treatment significantly increased both intratumor infiltration and anti-tumor function of neutrophils and T cells. Mechanistically, we found that cabozantinib treatment induced expression of neutrophil-related chemokines (CCL11 and CXCL12) and T cell-related chemokines (CCL8 and CX3CL1) in the tumor microenvironment. Furthermore, depletion of neutrophils and CD8+ T cells compromised the therapeutic efficacy of cabozantinib. Importantly, cabozantinib treatment induced long-term anti-tumor T cell response. Conclusions Our study revealed novel mechanisms of the therapeutic effects of cabozantinib on RCC by activating both neutrophil-mediated innate immunity and T cell-mediated adaptive immunity. These findings are of great significance for guiding the clinical use of cabozantinib and provide a good candidate for future combination therapy with T-cell therapies or other immunotherapies.
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Affiliation(s)
- Hongyan Liu
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Shishuo Sun
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Gang Wang
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Mengmeng Lu
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaokang Zhang
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaohuan Wei
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaoge Gao
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chao Huang
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhen Li
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Junnian Zheng
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Qing Zhang
- Cancer Institute, Xuzhou Medical University, Xuzhou, China.,Center of Clinical Oncology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Biomarkers for Malignant Pleural Mesothelioma-A Novel View on Inflammation. Cancers (Basel) 2021; 13:cancers13040658. [PMID: 33562138 PMCID: PMC7916017 DOI: 10.3390/cancers13040658] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 12/14/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive disease with limited treatment response and devastating prognosis. Exposure to asbestos and chronic inflammation are acknowledged as main risk factors. Since immune therapy evolved as a promising novel treatment modality, we want to reevaluate and summarize the role of the inflammatory system in MPM. This review focuses on local tumor associated inflammation on the one hand and systemic inflammatory markers, and their impact on MPM outcome, on the other hand. Identification of new biomarkers helps to select optimal patient tailored therapy, avoid ineffective treatment with its related side effects and consequently improves patient's outcome in this rare disease. Additionally, a better understanding of the tumor promoting and tumor suppressing inflammatory processes, influencing MPM pathogenesis and progression, might also reveal possible new targets for MPM treatment. After reviewing the currently available literature and according to our own research, it is concluded that the suppression of the specific immune system and the activation of its innate counterpart are crucial drivers of MPM aggressiveness translating to poor patient outcome.
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28
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Padmavathi R, Chandrasekaran D, Sundaram S, Maheshkumar K, Kathiresan N. Preoperative neutrophil–lymphocyte ratio/platelet–lymphocyte ratio: A potential and economical marker for renal cell carcinoma. J Cancer Res Ther 2021; 18:1635-1639. [DOI: 10.4103/jcrt.jcrt_482_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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29
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Hu X, Liao DW, Yang ZQ, Yang WX, Xiong SC, Li X. Sarcopenia predicts prognosis of patients with renal cell carcinoma: A systematic review and meta-analysis. Int Braz J Urol 2020; 46:705-715. [PMID: 32213202 PMCID: PMC7822353 DOI: 10.1590/s1677-5538.ibju.2019.0636] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/13/2019] [Indexed: 02/08/2023] Open
Abstract
Sarcopenia, a concept reflecting the loss of skeletal muscle mass, was reported to be associated with the prognosis of several tumors. However, the prognostic value of sarcopenia in patients with renal cancer remains unclear. We carried out this metaanalysis and systematic review to evaluate the prognostic value of sarcopenia in patients with renal cell carcinomas. We comprehensively searched PubMed, Embase, and Cochrane Library from inception to December 2018. Hazard ratio (HR) and 95% confidence interval (CI) were pooled together. A total of 5 studies consisting of 771 patients were enrolled in this quantitative analysis, 347 (45.0%) of which had sarcopenia. Patients with sarcopenia had a worse OS compared with those without sarcopenia (HR=1.76; 95%CI, 1.35-2.31; P <0.001). In the subgroup of patients with localized and advanced/metastatic diseases, sarcopenia was also associated with poor OS (HR=1.48, P=0.039; HR=2.14, P <0.001; respectively). With a limited sample size, we did not observe difference of PFS between two groups (HR=1.56, 95% CI, 0.69-3.50, P=0.282). In the present meta-analysis, we observed that patients with sarcopenia had a worse OS compared with those without sarcopenia in RCC. Larger, preferably prospective studies, are needed to confirm and update our findings.
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Affiliation(s)
- Xu Hu
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Du-Wu Liao
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Zhi-Qiang Yang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Wei-Xiao Yang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - San-Chao Xiong
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xiang Li
- Department of Urology, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Street, Chengdu, 610041, People's Republic of China
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Cupp MA, Cariolou M, Tzoulaki I, Aune D, Evangelou E, Berlanga-Taylor AJ. Neutrophil to lymphocyte ratio and cancer prognosis: an umbrella review of systematic reviews and meta-analyses of observational studies. BMC Med 2020; 18:360. [PMID: 33213430 PMCID: PMC7678319 DOI: 10.1186/s12916-020-01817-1] [Citation(s) in RCA: 229] [Impact Index Per Article: 57.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/15/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although neutrophils have been linked to the progression of cancer, uncertainty exists around their association with cancer outcomes, depending on the site, outcome and treatments considered. We aimed to evaluate the strength and validity of evidence on the association between either the neutrophil to lymphocyte ratio (NLR) or tumour-associated neutrophils (TAN) and cancer prognosis. METHODS We searched MEDLINE, Embase and Cochrane Database of Systematic Reviews from inception to 29 May 2020 for systematic reviews and meta-analyses of observational studies on neutrophil counts (here NLR or TAN) and specific cancer outcomes related to disease progression or survival. The available evidence was graded as strong, highly suggestive, suggestive, weak or uncertain through the application of pre-set GRADE criteria. RESULTS A total of 204 meta-analyses from 86 studies investigating the association between either NLR or TAN and cancer outcomes met the criteria for inclusion. All but one meta-analyses found a hazard ratio (HR) which increased risk (HR > 1). We did not find sufficient meta-analyses to evaluate TAN and cancer outcomes (N = 9). When assessed for magnitude of effect, significance and bias related to heterogeneity and small study effects, 18 (9%) associations between NLR and outcomes in composite cancer endpoints (combined analysis), cancers treated with immunotherapy and some site specific cancers (urinary, nasopharyngeal, gastric, breast, endometrial, soft tissue sarcoma and hepatocellular cancers) were supported by strong evidence. CONCLUSION In total, 60 (29%) meta-analyses presented strong or highly suggestive evidence. Although the NLR and TAN hold clinical promise in their association with poor cancer prognosis, further research is required to provide robust evidence, assess causality and test clinical utility. TRIAL REGISTRATION PROSPERO CRD42017069131 .
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Affiliation(s)
- Meghan A Cupp
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
| | - Margarita Cariolou
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
| | - Ioanna Tzoulaki
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Dagfinn Aune
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Evangelos Evangelou
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Antonio J Berlanga-Taylor
- Department of Epidemiology & Biostatistics, MRC Centre for Environment and Health, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, UK.
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Patel A, Ravaud A, Motzer RJ, Pantuck AJ, Staehler M, Escudier B, Martini JF, Lechuga M, Lin X, George DJ. Exploratory analysis of the platelet-to-lymphocyte ratio prognostic value in the adjuvant renal cell cancer setting. Future Oncol 2020; 17:403-409. [PMID: 33028084 PMCID: PMC8488532 DOI: 10.2217/fon-2020-0652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: To examine the prognostic value of the platelet-to-lymphocyte ratio (PLR) in the adjuvant renal cell carcinoma setting. Materials & methods: Patients received adjuvant sunitinib (50 mg/day; 4 weeks on/2 weeks off) or placebo. The primary end point was disease-free survival (DFS). Results: In 609 patients, DFS was similar for baseline PLR <140 versus ≥140 overall (median: 6.4 vs 5.9 years; hazard ratio: 0.9; 95% CI: 0.7–1.2). A ≥25% decrease in PLR at week 4 overall was associated with longer DFS versus no change (hazard ratio: 0.8; 95% CI: 0.6–1.0). Conclusion: Baseline PLR was not prognostic for DFS with adjuvant sunitinib treatment in patients with renal cell carcinoma. Clinical Trials Registration: NCT00375674 (ClinicalTrials.gov)
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Affiliation(s)
| | - Alain Ravaud
- Bordeaux University Hospital, 33000 Bordeaux, France
| | - Robert J Motzer
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Allan J Pantuck
- UCLA David Geffen School of Medicine, Los Angeles, CA 90094, USA
| | | | | | | | | | - Xun Lin
- Pfizer Inc., La Jolla, CA 92121, USA
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Abdou E, Pedapenki RM, Abouagour M, Zar AR, Dawoud E, Elshourbagy D, Al-Shamsi HO, Grande E. Patient selection and risk factors in the changing treatment landscape of metastatic renal cell carcinoma. Expert Rev Anticancer Ther 2020; 20:831-840. [PMID: 32930617 DOI: 10.1080/14737140.2020.1810572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The approval of combination treatments for metastatic renal cell carcinoma (mRCC) represents a major change in the clinical management of this malignancy. Updated treatment guidelines differentiate first-line mRCC treatment by patient risk group as defined by prognostic models and the number of risk factors. AREAS COVERED Current prognostic models, with a focus on the International Metastatic RCC Database Consortium and the Memorial Sloan Kettering Cancer Center models, the heterogeneity of the intermediate risk group, and first- and second-line mRCC treatment outcomes according to patient risk group are discussed. Consideration is given to the future direction of treatment selection strategies including refinement of prognostic factors, genetic biomarkers and gene signatures. EXPERT OPINION Current prognostic models require updating, but initial data suggests they are effective in stratifying patients treated with immune checkpoint inhibitors or combination therapy. Treatment selection for patients with 1-2 risk factors may require further consideration due to the heterogeneous nature of the intermediate risk group. Future prognostic models may benefit from inclusion of gene signatures and stratification by molecular subtype. Prognostic risk factors are not the only consideration in treatment selection; tumor burden, location of metastases, and comorbidities, among other factors, should also be considered.
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Affiliation(s)
- Ehab Abdou
- Medical Oncology, Kuwait Cancer Control Center, Shuwaikh, Kuwait
| | | | | | - Abdul R Zar
- Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar
| | - Emad Dawoud
- Medical oncology, Tawam Hospital, Al Ain, UAE
| | | | - Humaid O Al-Shamsi
- College of Medicine, University of Sharjah, Sharjah, UAE.,Emirates Oncology Society, Dubai, UAE
| | - Enrique Grande
- Department of Medical Oncology, MD Anderson Cancer Center, Madrid, Spain
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Tornberg SV, Nisen H, Järvinen P, Järvinen R, Kilpeläinen TP, Taari K, Stenman UH, Visapää H. Serum tumour associated trypsin inhibitor, as a biomarker for survival in renal cell carcinoma. Scand J Urol 2020; 54:413-419. [PMID: 32748674 DOI: 10.1080/21681805.2020.1798501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Tumour associated trypsin inhibitor (TATI) is a peptide that is a marker for several tumours. TATI may also behave as an acute phase reactant in severe inflammatory disease. Overexpression of TATI predicts an unfavourable outcome for many cancers. This study aimed to evaluate the prognostic value of pre- and postoperative concentration of TATI in serum (S-TATI) of patients with renal cell carcinoma (RCC). MATERIALS AND METHODS S-TATI was determined by time resolved immunofluorometric assay in preoperative and postoperative samples that were collected from 132 RCC patients, who underwent partial or complete nephrectomy in Helsinki University Hospital from May 2005 to July 2010. RESULTS Preoperative S-TATI was significantly associated with tumour stage, lymph-node involvement, metastatic stage, Chronic Kidney Disease Stage (CKD grade), and preoperative C-reactive protein level (p < 0.05). Postoperative S-TATI was significantly associated only with CKD grade (p < 0.001). Multivariate Cox regression analysis of postoperative S-TATI, as a continuous variable, was an independent prognostic factor for overall survival (HR = 1.01, 95% CI = 1.00-1.01, p = 0.03) and cancer-specific survival (CSS) (HR = 1.01, 95% CI = 1.00-1.02, p = 0.004). CONCLUSIONS Our data suggest that elevated postoperative S-TATI may be associated with adverse prognosis in RCC patients.
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Affiliation(s)
- Sara V Tornberg
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harry Nisen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Petrus Järvinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riikka Järvinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas P Kilpeläinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kimmo Taari
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harri Visapää
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Nader Marta G, Isaacsson Velho P, Bonadio RRC, Nardo M, Faraj SF, de Azevedo Souza MCL, Muniz DQB, Bastos DA, Dzik C. Prognostic Value of Systemic Inflammatory Biomarkers in Patients with Metastatic Renal Cell Carcinoma. Pathol Oncol Res 2020; 26:2489-2497. [DOI: 10.1007/s12253-020-00840-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/10/2020] [Indexed: 12/20/2022]
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Patel A, Ravaud A, Motzer RJ, Pantuck AJ, Staehler M, Escudier B, Martini JF, Lechuga M, Lin X, George DJ. Neutrophil-to-Lymphocyte Ratio as a Prognostic Factor of Disease-free Survival in Postnephrectomy High-risk Locoregional Renal Cell Carcinoma: Analysis of the S-TRAC Trial. Clin Cancer Res 2020; 26:4863-4868. [PMID: 32546645 DOI: 10.1158/1078-0432.ccr-20-0704] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/28/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE In the S-TRAC trial, adjuvant sunitinib improved disease-free survival (DFS) compared with placebo in patients with locoregional renal cell carcinoma (RCC) at high risk of recurrence. This post hoc exploratory analysis investigated the neutrophil-to-lymphocyte ratio (NLR) for predictive and prognostic significance in the RCC adjuvant setting. EXPERIMENTAL DESIGN Kaplan-Meier estimates and Cox proportional analyses were performed on baseline NLR and change from baseline at week 4 to assess their association with DFS. Univariate P values were two-sided and based on an unstratified log-rank test. RESULTS 609 of 615 patients had baseline NLR values; 574 patients had baseline and week 4 values. Sunitinib-treated patients with baseline NLR <3 had longer DFS versus placebo (7.1 vs. 4.7; HR, 0.71; P = 0.02). For baseline NLR ≥3, DFS was similar regardless of treatment (sunitinib 6.8 vs. placebo not reached; HR, 1.03; P = 0.91). A ≥25% NLR decrease at week 4 was associated with longer DFS versus no change (6.8 vs. 5.3 years; HR, 0.71; P = 0.01). A greater proportion of sunitinib-treated patients had ≥25% NLR decrease at week 4 (71.2%) versus placebo (17.4%). Patients with ≥25% NLR decrease at week 4 received a higher median cumulative sunitinib dose (10,137.5 mg) versus no change (8,168.8 mg) or ≥25% increase (6,712.5 mg). CONCLUSIONS In the postnephrectomy high-risk RCC patient cohort, low baseline NLR may help identify those most suitable for adjuvant sunitinib. A ≥25% NLR decrease at week 4 may be an early indicator of those most likely to tolerate treatment and derive DFS benefit.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Xun Lin
- Pfizer Inc, La Jolla, California
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Liu J, Zhang W, Niu R, Li Y, Zhou X, Han X. A combination of the preoperative neutrophil-to-lymphocyte and lymphocyte-to-monocyte ratios as a useful predictor of survival outcomes following the transarterial chemoembolization of huge hepatocellular carcinoma. Saudi Med J 2020; 41:376-382. [PMID: 32291424 PMCID: PMC7841607 DOI: 10.15537/smj.2020.4.24911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives: To investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) plus the lymphocyte-to-monocyte ratio (LMR) to predict survival outcomes in huge hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE). Methods: There were 180 huge HCC patients undergoing TACE between 2011 and 2017 were retrospectively analyzed. Patients who has an increased NLR (>3.94) and a decreased LMR (≤2.20) were assessed score 2 according to receiver operating characteristic (ROC) curve, and patients who were assigned with 1, with one of these characteristic or 0 with neither of these characteristics. We used univariate and multivariate analyses for evaluations of the predicative NLR, LMR and other values about overall survival (OS) using multivariate Cox’s regression. Results: The liver function index such as aspartate transaminase, alanine transaminase, and total bilirubin, as well as inflammatory biomarkers like absolute neutrophil count, monocyte count, lymphocyte count, seemed much larger than the groups with an NLR-LMR score of 2 than in the other 2 groups (p<0.05 for all), including BCLC stage. Higher NLR plus a low level of LMR predicted a short median OS. Multivariate Cox’s regression revealed that an NLR-LMR score of 2 was a useful predictor of OS in huge HCC patients after TACE. Conclusion: The pretreatment NLR plus LMR are effective for predicting survival outcomes in huge HCC patients after TACE.
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Affiliation(s)
- Juanfang Liu
- Department of Interventional Radiology, Thee First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. E-mail.
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Zheng C, Liu S, Feng J, Zhao X. Prognostic Value of Inflammation Biomarkers for Survival of Patients with Neuroblastoma. Cancer Manag Res 2020; 12:2415-2425. [PMID: 32280277 PMCID: PMC7132027 DOI: 10.2147/cmar.s245622] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 03/18/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose The prognostic significance of inflammation-based biomarkers for neuroblastoma (NB) has not been investigated before. The aim of this study was to evaluate the prognostic value of pre-treatment inflammation biomarkers in children patients with NB. Patients and Methods Patients diagnosed with NB from 2008 to 2016 in our institution were enrolled in this study. The clinical data and survival outcomes were retrospectively reviewed. Inflammation biomarkers or scores including C-reactive protein (CRP), albumin (ALB), Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), high-sensitivity modified Glasgow Prognostic Score (Hs-mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and system inflammation index (SII) were tested in this study. Univariate and multivariate survival analyses were performed to assess the prognostic value of these inflammation indicators for overall survival (OS) of children with NB. Kaplan–Meier survival curves were also conducted. Results A total of 70 children diagnosed with neuroblastoma were enrolled in this study. NLR, PLR, LMR and SII were found to be not predictive of OS for NB patients. However, CRP, ALB, GPS and CAR were significantly associated with OS of NB patients. Multivariate analysis adjusting for age, sex, histology, tumor size, tumor stage and metastasis revealed that ALB, CAR, GPS and Hs-mGPS were significantly associated with OS of NB patients. Receiver operating characteristic (ROC) curves and Akaike Information Criterion (AIC) analyses revealed that Hs-mGPS is superior to other inflammation biomarkers in predicting OS of NB patients. Subgroup survival analysis for immature NB patients revealed similar results. Conclusion Hs-mGPS is an effective prognostic factor for OS of patients with NB and is promising to be used as a factor for risk stratification and an indicator for more aggressive therapy.
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Affiliation(s)
- Chen Zheng
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Shuaibin Liu
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Jiexiong Feng
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Xiang Zhao
- Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
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Stanzi A, Verzoni E, Ruggirello M, Rolli L, Pastorino U. Post-surgical Regression of Thoracic Metastases After Salvage Lobectomy for Recurrent Renal Cell Carcinoma. Clin Genitourin Cancer 2019; 18:e284-e288. [PMID: 31879241 DOI: 10.1016/j.clgc.2019.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 01/17/2023]
Affiliation(s)
- Alessia Stanzi
- Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - Elena Verzoni
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Luigi Rolli
- Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Ugo Pastorino
- Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Lee A, Lee HJ, Huang HH, Tay KJ, Lee LS, Sim SPA, Ho SSH, Yuen SPJ, Chen K. Prognostic Significance of Inflammation-associated Blood Cell Markers in Nonmetastatic Clear Cell Renal Cell Carcinoma. Clin Genitourin Cancer 2019; 18:304-313. [PMID: 31892491 DOI: 10.1016/j.clgc.2019.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Our objective was to evaluate the effect of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and red blood cell distribution width (RDW) on the survival outcomes of nonmetastatic clear cell renal cell carcinoma (ccRCC). MATERIALS AND METHODS We accessed our single-center, urologic-oncologic registry to extract the data for patients who had undergone nephrectomy for nonmetastatic ccRCC. The optimal cutoff for these markers was determined using X-tile software, and survival analyses using Cox regression were performed. RESULTS A total of 687 patients had undergone nephrectomy. The optimal cutoffs for NLR, PLR, LMR, and RDW were 3.3, 210, 2.4, and 14.3%, respectively. The NLR, PLR, LMR, and RDW were significantly associated with a larger pathologic tumor size, and stage, more aggressive Fuhrman grade, and the presence of tumor necrosis. After adjusting for age, baseline Eastern Cooperative Oncology Group, pathologic tumor and nodal stage, and Fuhrman grade, only PLR remained an independent prognostic marker for both cancer-specific survival (hazard ratio, 2.69; 95% confidence interval, 1.36-5.33; P = .004) and overall survival (hazard ratio, 2.19; 95% confidence interval, 1.36-3.50; P = .001). When the PLR was included with the Leibovich score and University of California, Los Angeles, integrated staging system, the Harrell's c-index increased from 0.854 to 0.876 and 0.751 to 0.810, respectively, for cancer-specific survival at 5 years after nephrectomy. When risk stratified by the Leibovich risk group and UCLA integrated staging system, PLR was a significant prognostic factor only within the intermediate- to high-risk groups. CONCLUSIONS PLR is a robust prognostic marker in nonmetastatic ccRCC that clearly outperforms other inflammatory indexes in those who had undergone nephrectomy. However, its prognostic effect was limited in the low-risk category of ccRCC.
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Affiliation(s)
- Alvin Lee
- Department of Urology, Singapore General Hospital, Singapore
| | - Han Jie Lee
- Department of Urology, Singapore General Hospital, Singapore
| | - Hong Hong Huang
- Department of Urology, Singapore General Hospital, Singapore
| | - Kae Jack Tay
- Department of Urology, Singapore General Hospital, Singapore
| | - Lui Shiong Lee
- Department of Urology, Sengkang General Hospital, Singapore
| | | | | | | | - Kenneth Chen
- Department of Urology, Singapore General Hospital, Singapore.
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Zhang J, Feng W, Ye Z, Wei Y, Li L, Yang Y. Prognostic significance of platelet-to-lymphocyte ratio in patients with nasopharyngeal carcinoma: a meta-analysis. Future Oncol 2019; 16:117-127. [PMID: 31789058 DOI: 10.2217/fon-2019-0520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: Several studies reported the association of platelet-to-lymphocyte ratio (PLR) and prognosis in nasopharyngeal carcinoma (NPC), but the results remain controversial. Therefore, we investigated the prognostic value of PLR in NPC through meta-analysis. Materials & methods: A comprehensive literature search of PubMed, Embase and Web of Science was performed. Results: A total of 9 studies comprising of 3459 patients with NPC were included. The data demonstrated that an increased PLR predicted poor overall survival, progression-free survival and distant metastasis-free survival. There was no significant association between PLR and sex, age, T stage, N stage, tumor node metastasis (TNM) stage or intensity-modulated radiotherapy. Conclusion: This meta-analysis revealed that PLR might be a potential predicative biomarker of poor prognosis in patients with NPC.
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Affiliation(s)
- Junkai Zhang
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Weineng Feng
- Department of Head & Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, PR China
| | - Zhihua Ye
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Ying Wei
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Lamei Li
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
| | - Yingyu Yang
- Department I of Medical Oncology Center, Zhongshan Hospital of Sun Yat-sen University, People's Hospital of Zhongshan City, Zhongshan, Guangdong 528403, PR China
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Xu WH, Wang J, Huo DZ, Yin GC, Cao DL, Shi GH, Qu YY, Ye DW, Zhang HL. C-Reactive Protein Levels and Survival Following Cytoreductive Nephrectomy in 118 Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib: A Retrospective Study. Med Sci Monit 2019; 25:8984-8994. [PMID: 31769434 PMCID: PMC6897293 DOI: 10.12659/msm.918635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background This study aimed to evaluate the factors associated with a survival benefit for patients with metastatic renal cell carcinoma (mRCC) treated with sunitinib, with and without cytoreductive nephrectomy (CN). Material/Methods This retrospective clinical study included 118 patients with mRCC who were treated with CN and sunitinib (CN-sunitinib) (N=70) and with sunitinib-alone (N=48). Categorical clinicopathological variables were compared with hypothesis tests using contingency tables and a chi-squared test. Independent indicators for progression-free survival (PFS) and overall survival (OS) were analyzed with univariate and multivariate Cox regression models. The Kaplan-Meier method and log-rank test were used to evaluate patient survival. Results The median PFS and OS for the 118 patients were 8.38 and 15.48 months, respectively. There were no significant differences between the CN-sunitinib group and the sunitinib-alone group for either PFS (7.2 months vs. 11.6 months; P=0.525) or OS (16.7 months vs. 15.2 months; P=0.839). Stratification of patients based on clinicopathological characteristics showed that CN was significantly associated with reduced PFS and OS for patients with lymph node metastasis (PFS, P<0.001; OS, P<0.001) and high International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk scores (PFS, P=0.003; OS, P=0.011). However, CN was associated with a significant survival benefit for patients with low levels of serum C-reactive protein (CRP<10 mg/L) (PFS, P=0.026; OS, P=0.007). Conclusions Sunitinib-alone without CN improved the survival of patients with mRCC who had high IMDC risk scores or lymph node metastasis. CN and sunitinib resulted in significantly improved survival in patients with low serum CRP.
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Affiliation(s)
- Wen-Hao Xu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China (mainland).,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Jun Wang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China (mainland).,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Da-Zhu Huo
- Department of Research Management, Fudan University Shanghai Cancer Center, Shanghai, China (mainland)
| | - Guo-Cai Yin
- Clinical Medicine, Jining Medical University, Jining, Shandong, China (mainland)
| | - Da-Long Cao
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China (mainland).,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Guo-Hai Shi
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China (mainland).,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Yuan-Yuan Qu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China (mainland).,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Ding-Wei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China (mainland).,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
| | - Hai-Liang Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China (mainland).,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (mainland)
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Hua X, Chen J, Wu Y, Sha J, Han S, Zhu X. Prognostic role of the advanced lung cancer inflammation index in cancer patients: a meta-analysis. World J Surg Oncol 2019; 17:177. [PMID: 31677642 PMCID: PMC6825711 DOI: 10.1186/s12957-019-1725-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023] Open
Abstract
Background Inflammation plays a critical role in the development and progression of cancers. The advanced lung cancer inflammation index (ALI) is thought to be able to reflect systemic inflammation better than current biomarkers. However, the prognostic significance of the ALI in various types of cancer remains unclear. Our meta-analysis aimed to comprehensively investigate the relationship between the ALI and oncologic outcomes to help physicians better assess the prognosis of cancer patients. Methods The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched for relevant studies. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated and pooled from the included studies. Furthermore, a sensitivity analysis was performed to evaluate the reliability of the articles. Finally, Begg’s test, Egger’s test, and the funnel plot were applied to assess the significance of publication bias. Results In total, 1736 patients from nine studies were included in our meta-analysis. The median cutoff value for the ALI was 23.2 (range, 15.5–37.66) in the analyzed studies. The meta-analysis showed that there was a statistically significant relationship between a low ALI and worse overall survival (OS) in various types of cancer (HR = 1.70, 95% CI = 1.41–1.99, P < 0.001). Moreover, results from subgroup meta-analysis showed that the ALI had a significant prognostic value in non-small cell lung cancer, small cell lung cancer, colorectal cancer, head and neck squamous cell carcinoma, and diffuse large B cell lymphoma (P < 0.05 for all). Conclusions These results showed that a low ALI was associated with poor OS in various types of cancer, and the ALI could act as an effective prognostic biomarker in cancer patients.
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Affiliation(s)
- Xin Hua
- Medical School of Southeast University, Nanjing, 210009, China
| | - Jing Chen
- Department of Respiratory, Zhongda Hospital of Southeast University, Dingjiaqiao 87, Gulou District, Nanjing, 210009, China
| | - Ying Wu
- Department of Respiratory, Zhongda Hospital of Southeast University, Dingjiaqiao 87, Gulou District, Nanjing, 210009, China
| | - Jun Sha
- Medical School of Southeast University, Nanjing, 210009, China
| | - Shuhua Han
- Department of Respiratory, Zhongda Hospital of Southeast University, Dingjiaqiao 87, Gulou District, Nanjing, 210009, China
| | - Xiaoli Zhu
- Medical School of Southeast University, Nanjing, 210009, China. .,Department of Respiratory, Zhongda Hospital of Southeast University, Dingjiaqiao 87, Gulou District, Nanjing, 210009, China.
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Huszno J, Kolosza Z. Prognostic value of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratio in breast cancer patients. Oncol Lett 2019; 18:6275-6283. [PMID: 31788105 DOI: 10.3892/ol.2019.10966] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 05/29/2019] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to assess the blood the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) as prognostic factors in breast cancer (BC) patients. A retrospective analysis of 436 BC patients who were treated at COI (Gliwice, Poland) between January 2005 and June 2018 was performed. The prognostic value [overall survival (OS)] of the pre-treatment PLR, NLR and MLR was assessed by univariate and multivariate analysis. The 5-year OS was lower in the NLR >2.65 compared with that in the NLR≤2.65 group (82.5 vs. 89.6%; P=0.053), and significantly lower in the subgroup of triple-negative breast cancer (TNBC; 70.3 vs. 89.3%; P=0.034) and in patients whose tumors had an estrogen receptor-negative [ER(-)] status (66.6 vs. 83.6%; P=0.018). The 5-year OS was lower in patients with PLR >190.9 compared with that in the PLR≤190.9 group (78.7 vs. 89.4%; P=0.020). A poor OS rate associated with an elevated PLR was also observed in the subgroups with TNBC (68.2 vs. 88.5%; P=0.032) and with ER(-) status tumors (57.7 vs. 83.6%, P=0.002). An elevated MLR (>0.28) was not associated with OS time (P=0.830). Multivariate analysis revealed that the NLR and PLR were insignificant negative prognostic factors, except for the subgroup of patients with ER(-) tumors, where an elevated NLR [hazard ratio (HR)=2.40; 95% confidence interval (CI): 1.20-4.80; P=0.013] and a higher PLR (HR=2.51; 95%CI: 1.23-5.14; P=0.012) were independent prognostic factors for poor OS together with lymph node metastasis ((HR=5.47; 95%CI: 2.46-12.15; P=0.0001 and HR=4.82; 95% CI: 2.15-10.78; P=0.0001), respectively. The present results revealed that an elevated NLR (>2.65) and PLR (>190.9) are associated with poor OS in BC patients. In the ER(-) subgroup of patients, an elevated NLR and PLR were significant independent prognostic factors. However, the MLR did not affect OS.
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Affiliation(s)
- Joanna Huszno
- I Radiation and Clinic Oncology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland.,Genetic Outpatient Clinic, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland
| | - Zofia Kolosza
- Department of Medical Physics, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland
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Lei YY, Li YT, Hu QL, Wang J, Sui AX. Prognostic impact of neutrophil-to-lymphocyte ratio in gliomas: a systematic review and meta-analysis. World J Surg Oncol 2019; 17:152. [PMID: 31472673 PMCID: PMC6717646 DOI: 10.1186/s12957-019-1686-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 08/06/2019] [Indexed: 02/07/2023] Open
Abstract
Background In some malignant tumors, a high neutrophil-to-lymphocyte ratio (NLR) is connected with unfavorable prognosis. Nevertheless, the prognostic value of the NLR in gliomas remains disputed. The clinical significance of the NLR in gliomas was investigated in our study. Methods The databases, PubMed, Embase, and the Cochrane Library, were searched using words like “glioma,” “glioblastoma,” “neutrophil-to-lymphocyte ratio,” and others through May 2019. We evaluated the significance of NLR on overall survival (OS) of patients with gliomas in our study. Results Finally, 16 cohorts with 2275 patients were analyzed. The pooled analysis revealed that an elevated NLR was connected with unfavorable OS (hazards ratio (HR): 1.43, 95% confidence interval (CI): 1.27–1.62) outcomes of patients with gliomas. Conclusion A high NLR can be considered a high-risk prognostic factor in gliomas, and more adjuvant chemotherapy should be recommended for high-risk patients. Electronic supplementary material The online version of this article (10.1186/s12957-019-1686-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yu-Ying Lei
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Yi-Tong Li
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Qi-Lu Hu
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Juan Wang
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China
| | - Ai-Xia Sui
- Department of Oncology, Hebei General Hospital, Shijiazhuang, 050051, Hebei, China.
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Song H, Xu B, Luo C, Zhang Z, Ma B, Jin J, Zhang Q. The prognostic value of preoperative controlling nutritional status score in non-metastatic renal cell carcinoma treated with surgery: a retrospective single-institution study. Cancer Manag Res 2019; 11:7567-7575. [PMID: 31496811 PMCID: PMC6693320 DOI: 10.2147/cmar.s209418] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/25/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to investigate the significance of the controlling nutritional status (CONUT) score as a predictor for survival outcomes for non-metastatic renal cell carcinoma (RCC) patients. Methods We retrospectively reviewed 325 patients who received surgical treatment for renal cell carcinoma between 2010 and 2012 at Peking University First Hospital. Patients were divided into two groups according to the optimal cut-off value of CONUT score. Kaplan–Meier method and log-rank test were used for survival analysis according to different CONUT groups. Cox proportional hazards regression models were performed to assess the prognostic value of clinicopathological parameters for overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) respectively. Results The optimal cut-off value of CONUT score was 3. High CONUT score significantly correlated to higher tumor grade (P<0.001), later pathological T stage (P<0.001) and tumor necrosis (P<0.001). Patients with higher CONUT score had worse OS (HR 5.34, 95% CI 2.29–12.46, P<0.001), CSS (HR 5.51, 95% CI 2.12–14.33, P<0.001) and DFS (HR 4.23, 95% CI 2.16–8.29, P<0.001). In multivariable analysis, high CONUT score was an independent risk factor for OS, CSS and DFS (OS: HR=3.36, 95% CI 1.73–6.56, P<0.001; CSS: HR=3.34, 95% CI 1.59–6.98, P=0.001; DFS: HR=1.85, ]95% CI 1.07–3.21, P=0.029) Conclusion Preoperative CONUT score was an independent prognostic factor for OS, CSS and DFS in non-metastatic RCC patients treated with surgery.
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Affiliation(s)
- Haifeng Song
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Ben Xu
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Cheng Luo
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Zhenan Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Binglei Ma
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Jie Jin
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
| | - Qian Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, People's Republic of China.,Institute of Urology, Peking University, Beijing 100034, People's Republic of China.,National Research Center for Genitourinary Oncology, Beijing 100034, People's Republic of China
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Lactate Dehydrogenase-to-Lymphocyte Ratio Represents a Powerful Prognostic Tool of Metastatic Renal Cell Carcinoma Patients Treated with Tyrosine Kinase Inhibitors. Pathol Oncol Res 2019; 26:1319-1324. [PMID: 31388933 DOI: 10.1007/s12253-019-00707-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/01/2019] [Indexed: 01/19/2023]
Abstract
Inflammation parameters were verified to predict clinical outcomes of metastatic renal cell carcinoma (mRCC) patients treated with tyrosine kinase inhibitors (TKIs). Here, we developed a novel marker, lactate dehydrogenase (tumor burden marker) to lymphocytes (inflammation marker) ratio (LLR), aimed to reveal the prognostic role of LLR for mRCC patients treated with TKIs. We collected clinical data of mRCC patients treated with TKIs. Receiver operating curve analysis was used to determine the optimal cut-off value. The c-index method was used to determine the best predictive marker for overall survival (OS). Clinicopathological characteristics on OS and progression-free survival (PFS) were evaluated by univariate analysis, and multivariate analyses. LLR provided the greatest improvement in the c-index, and displayed the best marker of the prognostic accuracy for OS. Univariate analysis revealed that LLR, ECOG PS and IMDC risks were significant predictors of OS and PFS. However, multivariate analysis indicated that IMDC risks failed to predict PFS, and only showed predictor of OS. We finally stratifed patients into low LLR (<150) and high LLR (≥150) group with different clinical outcomes. LLR represents a powerful prognostic tool of clinical outcome in mRCC patients treated with TKIs.
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Konishi S, Hatakeyama S, Tanaka T, Ikehata Y, Tanaka T, Hamano I, Fujita N, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Yoshikawa K, Kawaguchi T, Masumori N, Kitamura H, Ohyama C. C-reactive protein/albumin ratio is a predictive factor for prognosis in patients with metastatic renal cell carcinoma. Int J Urol 2019; 26:992-998. [PMID: 31342557 DOI: 10.1111/iju.14078] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/02/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate the effect of pretreatment C-reactive protein/albumin ratio and modified Glasgow prognostic score on the prognosis in patients with metastatic renal cell carcinoma. METHODS A retrospective study was carried out in 176 patients with metastatic renal cell carcinoma who received first-line tyrosine kinase inhibitors. The effect of adding inflammatory prognostic scores to the International Metastatic Renal Cell Carcinoma Database Consortium model (International Metastatic Renal Cell Carcinoma Database Consortium-C-reactive protein/albumin ratio and International Metastatic Renal Cell Carcinoma Database Consortium-Glasgow prognostic score models) on overall survival was evaluated using receiver operating characteristic curves. The prognostic value of inflammatory prognostic scores (C-reactive protein/albumin ratio-modified Glasgow prognostic score) was tested using the Kaplan-Meier method and Cox proportional regression models. RESULTS Patients were stratified into two groups using the cut-off value of 0.05: C-reactive protein/albumin ratio-low (<0.05) and C-reactive protein/albumin ratio-high (≥0.05). The area under the curve was significantly higher in the International Metastatic Renal Cell Carcinoma Database Consortium-C-reactive protein/albumin ratio model (0.720) than that of the International Metastatic Renal Cell Carcinoma Database Consortium model (0.689) and the International Metastatic Renal Cell Carcinoma Database Consortium-modified Glasgow prognostic score model (0.703). Significant differences were observed in overall survival stratified by the number of risk factors in the International Metastatic Renal Cell Carcinoma Database Consortium-C-reactive protein/albumin ratio risk model between one or two and three or four factors (P < 0.001), and three or four and five or more factors (P = 0.001). For the patients in the International Metastatic Renal Cell Carcinoma Database Consortium intermediate-risk group, overall survival was significantly different between the C-reactive protein/albumin ratio-low and -high groups (P = 0.001), whereas it was not significantly different between the patients with one and two International Metastatic Renal Cell Carcinoma Database Consortium risk factors (P = 0.106). CONCLUSION The C-reactive protein/albumin ratio is a simple and independent predictor of overall survival in patients with metastatic renal cell carcinoma. The predictive activity was significantly improved in the International Metastatic Renal Cell Carcinoma Database Consortium-C-reactive protein/albumin ratio model compared with the International Metastatic Renal Cell Carcinoma Database Consortium/International Metastatic Renal Cell Carcinoma Database Consortium-modified Glasgow prognostic score models.
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Affiliation(s)
- Sakae Konishi
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshinori Ikehata
- Department of Urology, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Toshikazu Tanaka
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Toshiaki Kawaguchi
- Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroshi Kitamura
- Department of Urology, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Hu X, Wang Y, Yang WX, Dou WC, Shao YX, Li X. Modified Glasgow prognostic score as a prognostic factor for renal cell carcinomas: a systematic review and meta-analysis. Cancer Manag Res 2019; 11:6163-6173. [PMID: 31308752 PMCID: PMC6613602 DOI: 10.2147/cmar.s208839] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/06/2019] [Indexed: 02/05/2023] Open
Abstract
Objective The modified Glasgow prognostic score (mGPS), a combination of C-reactive protein (CRP) and albumin levels, reflects systemic inflammation and nutritional status. This score has been shown to have prognosis value for various tumors. In the present study, we evaluated the prognostic value of mGPS for patients with renal cell carcinoma (RCC). Methods Literature search was conducted based on PubMed, Embase, and Cochrane Central Register of Controlled Trials up to December 2018. We pooled HRs and 95% CIs to evaluate the correlation between mGPS and survival in patients with RCC. Results Twelve studies comprising 2,391 patients were included in the present study for quantitative synthesis. Our studies demonstrated that higher mGPS was significantly correlated to poor overall survival (HR=4.31; 95%CI, 2.78–6.68; P<0.001), cancer-specific survival (HR=5.88; 95%CI, 3.93–8.78; P<0.001), recurrence-free survival (HR=3.15; 95%CI, 2.07–4.79; P<0.001), and progression-free survival (HR=1.91; 95%CI, 1.27–2.89; P=0.002). Subgroup analyses also confirmed the overall results. Conclusion mGPS could serve as a predictive tool for the survival of patients with RCC. In the different subgroups, the results are also consistent with previous results. In conclusion, pretreatment higher mGPS is associated with poorer survival in patients with RCC. Further external validations are necessary to strengthen this concept.
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Affiliation(s)
- Xu Hu
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yan Wang
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Wei-Xiao Yang
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Wei-Chao Dou
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Yan-Xiang Shao
- West China School of Medicine/West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xiang Li
- Department of Urology, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, People's Republic of China
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Karagoz I, Yoldas H. Platelet to lymphocyte and neutrophil to lymphocyte ratios as strong predictors of mortality in intensive care population. ACTA ACUST UNITED AC 2019; 65:633-636. [PMID: 31166439 DOI: 10.1590/1806-9282.65.5.633] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 05/27/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Patients in intensive care units (ICU) have greater morbidity and mortality. We aimed to study neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the ICU population. METHODS Medical and laboratory data of patients treated in ICU were retrospectively analyzed. Patients were divided into deceased and survived groups. RESULTS The NLR of survived and deceased groups were 3.6 (0.2-31) and 9.5 (1-40), respectively (p<0.001). The PLR of the survived group (111 [16-537]) was significantly lower than the PLR of the deceased (209 [52-1143]), (p<0.001). An NLR higher than 4.9 had 84% sensitivity and 67% specificity is selecting deceased patients (AUC:0.80, p<0.001). A PLR higher than 112 had 83% sensitivity and 52% specificity in predicting deadly cases (AUC:0.76, p<0.001). Both PLR and NLR were significantly and positively correlated with c reactive protein levels. CONCLUSION We suggest that physicians should pay particular attention to the treatment of patients in ICU with elevated NLR and PLR.
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Affiliation(s)
- Ibrahim Karagoz
- Training and Research Hospital, Department of Anesthesiology and Reanimation, Bolu, Turkey
| | - Hamit Yoldas
- Training and Research Hospital, Department of Anesthesiology and Reanimation, Bolu, Turkey
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50
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Okita K, Hatakeyama S, Tanaka T, Ikehata Y, Tanaka T, Fujita N, Ishibashi Y, Yamamoto H, Yoneyama T, Hashimoto Y, Yoshikawa K, Kawaguchi T, Masumori N, Kitamura H, Ohyama C. Impact of Disagreement Between Two Risk Group Models on Prognosis in Patients With Metastatic Renal-Cell Carcinoma. Clin Genitourin Cancer 2019; 17:e440-e446. [DOI: 10.1016/j.clgc.2019.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/06/2019] [Accepted: 01/08/2019] [Indexed: 12/11/2022]
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