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Ouanes Y, Chaker K, Nouira Y. Prognostic significance of the preoperative platelet-lymphocyte ratio in nonmetastatic renal cell carcinoma: cross-sectional study. Ann Med Surg (Lond) 2023; 85:3833-3837. [PMID: 37554885 PMCID: PMC10406076 DOI: 10.1097/ms9.0000000000000862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/12/2023] [Indexed: 08/10/2023] Open
Abstract
UNLABELLED The prognostic significance of the platelet-lymphocyte ratio (PLR) in nonmetastatic renal cell carcinoma (RCC) is controversial, although it has been established as a prognostic factor in several cancers. OBJECTIVE The objective of our study was to evaluate the prognostic significance of the PLR in patients with nonmetastatic RCC. PATIENTS AND METHODS The authors performed a retrospective analysis of patients with nonmetastatic RCC who were operated between 2004 and 2020. Five years recurrence-free survival and metastasis-free survival were calculated. The prognostic significance of the preoperative PLR was assessed. The Kaplan-Meier method was utilized to graphically display survivor functions. Univariate and multivariate Cox's proportional hazards regression models were utilized to analyze the association between PLR and oncological outcomes. Differences were considered significant if P<0.05. RESULTS Two hundred and two patients were included. The mean follow-up was 56.8±3 months. Patients with a higher PLR had larger tumors (P=0.02), higher ASA score (P=0.001), symptomatic forms (P=0.01), and more frequent tumor necrosis (P=0.02). Recurrence-free survival and metastasis-free survival rates were significantly lower in patients with high PLR than in those with low ratios (each P<0.005). Multivariate analysis identified PLR as an independent predictor of recurrence-free survival (P=0.002) and metastasis-free survival (P<0.001). CONCLUSION A higher PLR was associated with aggressive renal cancer. In addition, the PLR was a significant prognostic factor for both recurrence-free survival and metastasis-free survival in patients with nonmetastatic RCC.
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Affiliation(s)
- Yassine Ouanes
- Department of Urology, LA RABTA Hospital, University of TUNIS EL MANAR, Tunis, Tunisia
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Chaker K, Ouanes Y, Dali KM, Bibi M, Messaoudi Y, Mosbehi B, Abid K, Sellami A, Ben Rhouma S, Nouira Y. Signification pronostique du rapport préopératoire neutrophiles-lymphocytes dans le cancer du rein non métastatique. Prog Urol 2022; 32:585-592. [DOI: 10.1016/j.purol.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/02/2022] [Accepted: 03/21/2022] [Indexed: 11/28/2022]
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Zhou X, Luo G. A meta-analysis of the platelet-lymphocyte ratio: A notable prognostic factor in renal cell carcinoma. Int J Biol Markers 2022; 37:123-133. [PMID: 35238678 DOI: 10.1177/03936155221081536] [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: 11/15/2022]
Abstract
BACKGROUND The platelet-lymphocyte ratio (PLR) has been assessed in some studies on renal cell carcinoma (RCC), but the results have been inconsistent. This meta-analysis aims to review and report the latest data regarding the prognostic role of the PLR in RCC patients. METHOD Articles were searched in the PubMed, EMBASE, and Cochrane Library electronic databases. Studies were filtered according to a selection strategy, and data corresponding to the index of interest were extracted. A fixed-effects model or random-effects model was selected based on heterogeneity. The sensitivity analysis was carried out by eliminating the studies one by one. Finally, funnel plots and Egger's test were used to assess publication bias, and the trim and fill method was used to assess the impact of bias on the results. RESULTS In total, 15,193 patients with RCC from 44 studies were included in this meta-analysis. The pooled analysis indicated that the higher the PLR was, the poorer the prognosis for RCC patients in terms of overall survival (hazard ratio (HR) = 1.01 (95% confidence interval (CI) 1.00, 1.02), P = 0.010), cancer-special survival (CSS) (HR = 1.21 (95% CI 1.00, 1.46), P = 0.05), progression-free survival (HR = 1.44 (95% CI 1.28, 1.62), P < 0.00001), recurrence-free survival (HR = 1.73 (95% CI 1.11, 2.71), P = 0.02), disease-free survival (HR = 1.63 (95% CI 0.91, 2.94), P = 0.01) and metastasis-free survival (HR = 1.223 (95% CI 0.712, 2.099), P = 0.466). In the subgroup analysis of high PLR, targeted treatment, TKI use, nivolumab use, surgical treatment, clear cell RCC, metastasis, Asian race, and high PLR were related to poor prognosis. CONCLUSION This study showed that a high PLR was associated with the poor prognosis of RCC patients, but more studies are needed to confirm the value of the PLR.
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Affiliation(s)
- Xiao Zhou
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Guangcheng Luo
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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Adapala RKR, Prabhu GGL, Sanman KN, Yalla DR, Shetty R, Venugopal P. Is preoperative neutrophil-to-lymphocyte ratio a red flag which can predict high-risk pathological characteristics in renal cell carcinoma? Urol Ann 2021; 13:47-52. [PMID: 33897164 PMCID: PMC8052900 DOI: 10.4103/ua.ua_34_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 01/28/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Renal cell carcinoma (RCC) is known to invoke both immunological and inflammatory responses. While the neutrophils mediate the tumor-induced inflammatory response, the lymphocytes bring about the various immunological events associated with it. The neutrophil-to-lymphocyte ratio (NLR) is a simple indicator of this dual response. We investigated the association between preoperative NLR and histopathological prognostic variables of RCC intending to find out whether it can be of value as a red flag capable of alerting the clinician as to the biological character of the tumor under consideration. Methods Preoperative NLR and clinicopathological variables, namely histological subtype, nuclear grade, staging, lymphovascular invasion, capsular invasion, tumor necrosis, renal sinus invasion, and sarcomatoid differentiation of 60 patients who underwent radical or partial nephrectomy, were analyzed to detect the association between the two. Results We found that mean preoperative NLR was significantly higher in clear-cell carcinomas (3.25 ± 0.29) when compared with nonclear-cell carcinomas (2.25 ± 0.63). There was a linear trend of NLR rise as the stage of the disease advanced. A significant rise in preoperative NLR was noted in tumors with various high-risk histopathological features such as tumor size, capsular invasion, tumor necrosis, and sarcomatoid differentiation. Conclusion Preoperative measurement of NLR is a simple test which may provide an early clue of high-risk pathological features of renal cell cancer.
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Affiliation(s)
| | - G G Laxman Prabhu
- Department of Urology, Kasturba Medical College Hospital, Mangalore, Karnataka, India
| | - K N Sanman
- Department of Urology, Kasturba Medical College Hospital, Mangalore, Karnataka, India
| | - Durga Rao Yalla
- Department of Biochemistry, Kasturba Medical College Hospital, Mangalore, Karnataka, India
| | - Ranjit Shetty
- Department of Urology, Kasturba Medical College Hospital, Mangalore, Karnataka, India
| | - P Venugopal
- Department of Biochemistry, Kasturba Medical College Hospital, Mangalore, Karnataka, India
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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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Nunno VD, Mollica V, Gatto L, Santoni M, Cosmai L, Porta C, Massari F. Prognostic impact of neutrophil-to-lymphocyte ratio in renal cell carcinoma: a systematic review and meta-analysis. Immunotherapy 2020; 11:631-643. [PMID: 30943858 DOI: 10.2217/imt-2018-0175] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIM Estimate prognosis and clinical outcome of patients with localized or metastatic renal cell carcinoma (RCC) is an important issue which drive our medical decisions. METHODS We carried out a meta-analysis of available clinical studies exploring neutrophil-to-lymphocyte ratio (NLR) in RCC in order to evaluate if this ratio could be correlated to overall survival (OS) and progression-free survival (PFS) of patients with localized/metastatic RCC. RESULTS In overall population higher NLR resulted in worst OS and PFS (OS pooled hazard ratio of 1.80; 95% CI: 1.61-2.00; I2 45%; PFS pooled hazard ratio of 1.69; 95% CI: 1.42-2.01; I2 81%), this negative correlation was also confirmed in both metastatic and nonmetastatic patients. CONCLUSION The NLR ratio is a variable correlated to prognosis in RCC patients.
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Affiliation(s)
| | - Veronica Mollica
- Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - Lidia Gatto
- Division of Oncology, S.Orsola-Malpighi Hospital, Bologna, Italy
| | | | - Laura Cosmai
- Onco-Nephrology Outpatient Clinic, Division of Nephrology & Dialysis, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Camillo Porta
- Department of Internal Medicine, University of Pavia & Division of Traslational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy
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Preoperative Neutrophil-to-Lymphocyte Ratio Was a Predictor of Overall Survival in Small Renal Cell Carcinoma: An Analysis of 384 Consecutive Patients. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8051210. [PMID: 32219142 PMCID: PMC7079219 DOI: 10.1155/2020/8051210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/07/2019] [Accepted: 01/29/2020] [Indexed: 12/12/2022]
Abstract
Objective The aim of this study was to investigate the prognostic significance of the preoperative neutrophil-to-lymphocyte ratio (NLR) in small renal cell carcinoma (sRCC, ≤4 cm). Methods This study was approved by the review board (NO.XYFY2019-KL032-01). Between 2007 and 2016, a total of 384 consecutive patients who underwent curative surgery for sRCC at our institution were evaluated. Patients were divided into high NLR and low NLR groups by plotting the NLR receiver operating characteristic curve. The Kaplan–Meier method was utilized to graphically display survivor functions. Univariate and multivariate Cox proportional hazards regression analysis addressed time to overall survival (OS) and cancer-specific survival (CSS). Results Of the 384 patients, 264 (68.8%) were males and 120 (31.2%) were females. Median follow-up time after surgical resection was 54 months. One hundred and eighty-seven (48.7%) patients had a high NLR (≥1.97), and the remaining 197 (51.3%) had a low NLR (<1.97). Patients with high NLR were more likely to be aged compared with patients with low NLR (P=0.028). High NLR was associated with decreased OS and CSS compared with low NLR (P=0.028). High NLR was associated with decreased OS and CSS compared with low NLR (P=0.028). High NLR was associated with decreased OS and CSS compared with low NLR (P=0.028). High NLR was associated with decreased OS and CSS compared with low NLR ( Conclusions Elevated preoperative NLR is an independent adverse prognostic factor for OS after surgery with curative intent for sRCC.
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Albisinni S, Pretot D, Al Hajj Obeid W, Aoun F, Quackels T, Peltier A, Roumeguère T. The impact of neutrophil-to-lymphocyte, platelet-to-lymphocyte and haemoglobin-to-platelet ratio on localised renal cell carcinoma oncologic outcomes. Prog Urol 2019; 29:423-431. [PMID: 31196826 DOI: 10.1016/j.purol.2019.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/04/2019] [Accepted: 05/18/2019] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are established markers of systemic inflammation. Moreover, anemia is a known adverse prognostic factor and reduced haemoglobin to platelet ratio (HPR) seems associate to poor outcomes in urothelial cancer. Aim of the current study was to explore the prognostic value of NLR, HPR and PLR in patients harboring localized RCC. Materials and Methods 184 patients undergoing partial and radical nephrectomy for renal mass in a single hospital were retrospectively analyzed. Uni- and multivariate logistic regressions were performed to assess associations between various risk factors, including NLR, PLR and HPR and locally advanced disease (≤pT2 vs.≥pT3) and tumor grade. Kaplan Meier curves and Cox regressions were constructed to assess the association of NLR, PLR and HPR to recurrence free survival (RFS), cancer specific survival (CSS) and overall survival (OS). To determine thresholds for variables, we considered the 75th percentile of our distribution of values, which was computed at 3.45 for NLR, 189 for PLR and 0.48 for HPR. A two-sided P<0.05 defined statistical significance. RESULTS Patients with an elevated NLR (>3.45) were more likely to present with≥pT3 stage (p=0.046). RFS was significantly different according to NLR value, with patients having an NLR>3.45 experiencing significantly worst RFS (P=0.019); similarly, an increased PLR was significantly associated to a reduced RFS (P=0.012). Restricting the Cox regression to patients with locally advanced disease (≥pT3), NLR was even more associated to recurrence (HR 3.22; 95%CI: 1.06-9.81, P=0.039). Patients exhibiting an NLR>3.45 (p=0.03) or a PLR>189 (P=0.005) did have a significantly worse CSS, while a HPR<0.48 did not predict CSS (P=0.12) on Kaplan Meier curves. Finally, an increased NLR (P=0.047), increased PLR (P=0.0006) and decreased HPR (P=0.05) were all associated to a poor overall survival on univariate analysis. On multivariate analysis, only HPR remained significantly predictive of OS (HR 0.077; 95%CI: 0.02-0.37, P=0.001). CONCLUSIONS In this single-center study analyzing non-metastatic RCC, an increased NLR was significantly associated to a reduced RFS, CSS and OS on univariate analyses and to RFS on multivariate analysis. Larger prospective studies are needed to validate our findings. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- S Albisinni
- Urology Department, université libre de Bruxelles, University Clinics of Brussels, hôpital Erasme, route de Lennik 808, Brussels, Belgium.
| | - D Pretot
- Urology Department, université libre de Bruxelles, University Clinics of Brussels, hôpital Erasme, route de Lennik 808, Brussels, Belgium
| | - W Al Hajj Obeid
- Urology Department, université libre de Bruxelles, University Clinics of Brussels, hôpital Erasme, route de Lennik 808, Brussels, Belgium; Urology Department, Saint George Hospital University Medical Center, Beyrouth, Lebanon
| | - F Aoun
- Urology Department, Institute Jules Bordet, Université libre de Bruxelles, Brussels, Belgium; Urology Department, Hôtel-Dieu de France, université Saint Joseph, Beyrouth, Lebanon
| | - T Quackels
- Urology Department, université libre de Bruxelles, University Clinics of Brussels, hôpital Erasme, route de Lennik 808, Brussels, Belgium
| | - A Peltier
- Urology Department, Institute Jules Bordet, Université libre de Bruxelles, Brussels, Belgium
| | - T Roumeguère
- Urology Department, université libre de Bruxelles, University Clinics of Brussels, hôpital Erasme, route de Lennik 808, Brussels, Belgium
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Åström M, Tajeddinn W, Karlsson MG, Linder O, Palmblad J, Lindblad P. Cytokine Measurements for Diagnosing and Characterizing Leukemoid Reactions and Immunohistochemical Validation of a Granulocyte Colony-Stimulating Factor and CXCL8-Producing Renal Cell Carcinoma. Biomark Insights 2018; 13:1177271918792246. [PMID: 30147294 PMCID: PMC6100120 DOI: 10.1177/1177271918792246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 07/11/2018] [Indexed: 12/17/2022] Open
Abstract
Background Various paraneoplastic syndromes are encountered in renal cell carcinomas. This case report illustrates that a paraneoplastic leukemoid reaction may precede the diagnosis of renal cell carcinoma and be explained by cytokine production from the cancer cells. Case presentations A 64-year-old man was referred for hematology workup due to pronounced leukocytosis. While being evaluated for a possible hematologic malignancy as the cause, he was found to have a metastasized renal cell carcinoma, and hyperleukocytosis was classified as a leukemoid reaction. A multiplex panel for measurement of 25 serum cytokines/chemokines showed highly elevated levels of granulocyte colony-stimulating factor (G-CSF) and CXCL8 (C-X-C-motif chemokine ligand 8, previously known as interleukin [IL]-8). By immunohistochemistry it was shown that the renal carcinoma cells expressed both these cytokines. Two additional, consecutive patients with renal cell carcinoma with paraneoplastic leukocytosis also showed elevated serum levels of CXCL8, but not of G-CSF. Nonparametric statistical evaluation showed significantly higher serum concentrations of CXCL8, IL-6, IL-10, monocyte chemoattractant protein 1 (MCP-1), and tumor necrosis factor, but lower interferon gamma (IFN-γ) and IL-1α, for the 3 renal cell carcinoma cases compared with healthy blood donors. Conclusions In suspected paraneoplastic leukocytosis, multiplex serum cytokine analyses may facilitate diagnosis and provide an understanding of the mechanisms for the reaction. In the index patient, combined G-CSF and CXCL8 protein expression by renal carcinoma cells was uniquely documented. A rapidly fatal course was detected in all 3 cases, congruent with the concept that autocrine/paracrine growth signaling in renal carcinoma cells may induce an aggressive tumor phenotype. Immune profiling studies could improve our understanding for possible targets when choosing therapies for patients with metastatic renal cell carcinoma.
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Affiliation(s)
- Maria Åström
- Division of Hematology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.,Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,iRiSC - Inflammatory Response and Infection Susceptibility Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Walid Tajeddinn
- iRiSC - Inflammatory Response and Infection Susceptibility Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mats G Karlsson
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Olle Linder
- Division of Hematology, Department of Medicine, Örebro University Hospital, Örebro, Sweden
| | - Jan Palmblad
- Division of Hematology, Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Per Lindblad
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Agizamhan S, Qu F, Liu N, Sun J, Xu W, Zhang L, Guo H, Gan W. Preoperative neutrophil-to-lymphocyte ratio predicts the surgical outcome of Xp11.2 translocation/TFE3 renal cell carcinoma patients. BMC Urol 2018; 18:60. [PMID: 29890986 PMCID: PMC5996532 DOI: 10.1186/s12894-018-0374-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 05/31/2018] [Indexed: 01/19/2023] Open
Abstract
Background The preoperative neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CRP/Alb ratio) and platelet-to-lymphocyte ratio (PLR) have been demonstrated to predict the clinical outcome of various human cancer, including renal cell carcinoma(RCC). The aim of our study was to explore the prognostic values of these ratios in patients with Xp11.2 translocation/TFE3 gene fusions renal cell carcinoma (Xp11.2 tRCC). Methods A retrospective multicentre study was performed in 82 Xp11.2 tRCC patients who underwent radical or partial nephrectomy. The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were determined by the receiver operating characteristic (ROC) analysis. The impact of the NLR, CRP/Alb ratio and PLR, as well as other clinicopathological characteristics, on disease-free survival (DFS) and overall survival (OS) were evaluated using the univariate and multivariate Cox regression analyses. Results The optimal cutoff values of the NLR, CRP/Alb ratio and PLR were set at 2.45, 140 and 0.08, respectively, according to the ROC analysis. Univariate analyses showed that the NLR, CRP/Alb ratio and PLR all were associated with DFS of Xp11.2 tRCC patients (P < 0.001, P = 0.005 and P = 0.001, respectively) and OS of Xp11.2 tRCC patients (P = 0.016, P = 0.003 and P = 0.014, respectively). Multivariate analysis indicated that the NLR was independently associated with DFS of Xp11.2 tRCC patients (hazard ratio [HR]: 4.25; 95% confidence interval [95% CI]: 1.19–15.18; P = 0.026) along with age (P = 0.004), the pT status (P < 0.001) and the pN status (P < 0.019), and the NLR (HR: 26.26; 95% CI: 1.44–480.3; P = 0.028) also was independently associated with OS in patients with Xp11.2 tRCC, along with age (P = 0.016) and a tumour thrombus (P = 0.007). Conclusion Overall, relatively high NLRs, CRP/Alb ratios and PLRs were associated with a poor prognosis of Xp11.2 tRCC patients; among of them, only the NLR independently predicted the progression of Xp11.2 tRCC, and the NLR may help to identify patients with high metastasis or relapse risk.
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Affiliation(s)
- Sezim Agizamhan
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Feng Qu
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Ning Liu
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Jing Sun
- Department of Oncology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Xu
- Department of Pathology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lihua Zhang
- Department of Pathology, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China
| | - Hongqian Guo
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China
| | - Weidong Gan
- Department of Urology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China.
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Qiu X, Song Y, Cui Y, Liu Y. Increased neutrophil-lymphocyte ratio independently predicts poor survival in non-metastatic triple-negative breast cancer patients. IUBMB Life 2018; 70:529-535. [PMID: 29707892 DOI: 10.1002/iub.1745] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 03/06/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Xiangting Qiu
- Department of Clinical Laboratory; Linyi Central Hospital; Linyi China
| | - Yucui Song
- Operating Room; Linyi Central Hospital; Linyi China
| | - Yanxiang Cui
- Department of Clinical Laboratory; Traditional Chinese Medical Hospital of Huangdao District; Qingdao China
| | - Yan Liu
- Medical Examination Center; Linyi Central Hospital; Linyi China
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The Prognostic Value of Platelet-to-Lymphocyte Ratio in Urological Cancers: A Meta-Analysis. Sci Rep 2017; 7:15387. [PMID: 29133845 PMCID: PMC5684392 DOI: 10.1038/s41598-017-15673-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/31/2017] [Indexed: 12/20/2022] Open
Abstract
The relationship of platelet-to-lymphocyte ratio (PLR) and survival in urological cancers remained inconsistent in previous studies. Therefore, we performed a meta-analysis to assess the prognostic significance of PLR in patients with urological cancers. A literature search was performed in the PubMed, Embase, and Web of Science up to July, 2017 and study quality was obtained using the Newcastle-Ottawa Scale. To estimate the association of PLR and overall survival (OS) and other survival outcomes in urological cancers, we used pooled hazard ratios (HRs). Subgroup analyses were conducted on different ethnics, sample sizes and cut-off values. 20 high quality studies involving 7562 patients with urological cancers were included in this meta-analysis. High pretreatment PLR was significantly associated with poor OS in patients with urological cancers (pooled HR = 1.58). Elevated PLR was also correlated with other survival outcomes. However, we found that PLR was significantly relevant to the OS of patients with different types of urological cancers except bladder cancer (BCa, HR = 1.16, 95%CI: 0.96–1.41). In conclusion, elevated PLR was negatively related to the OS of patients with urological cancers, except in BCa. However, more large scale prospective studies with high quality are required in the future.
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Wang X, Su S, Guo Y. The clinical use of the platelet to lymphocyte ratio and lymphocyte to monocyte ratio as prognostic factors in renal cell carcinoma: a systematic review and meta-analysis. Oncotarget 2017; 8:84506-84514. [PMID: 29137443 PMCID: PMC5663615 DOI: 10.18632/oncotarget.21108] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 09/03/2017] [Indexed: 12/27/2022] Open
Abstract
Conflicting evidence exists regarding the effect of platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) on the prognosis of renal cell carcinoma (RCC) patients. Here we quantify the prognostic impact of these biomarkers and assess their consistency in RCC. Eligible studies were retrieved from the PubMed, Embase and Web of Science databases. Pooled hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Sixteen studies containing 6,223 patients met criteria for inclusion. Overall, elevated PLR was associated with poorer overall survival (OS, HR 1.76, 95% CI 1.41-2.19, P < 0.001), progression-free survival (PFS, HR 2.81, 95% CI 1.40-5.63, P = 0.004) and recurrence-free survival (RFS, HR 2.64, 95% CI 1.35-5.14, P = 0.004). Conversely, high LMR was correlated with more favorable OS (HR 0.62, 95% CI 0.51-0.77, P < 0.001) and RFS (HR 0.53, 95% CI 0.42-0.67, P < 0.001). Moreover, low LMR was significantly associated with some clinicopathological characteristics that are indicative of poor prognosis and disease aggressiveness. By these results, elevated PLR was associated with poor outcomes, while high LMR correlated with more favorable survival in RCC patients. Pretreatment PLR and LMR can serve as prognostic factors in RCC patients.
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Affiliation(s)
- Xuemin Wang
- Department of Urology, The First Hospital of Shijiazhuang, Shijiazhuang 050011, Hebei Province, China
| | - Shiqiang Su
- Department of Urology, The First Hospital of Shijiazhuang, Shijiazhuang 050011, Hebei Province, China
| | - Yuanshan Guo
- Department of Urology, The First Hospital of Shijiazhuang, Shijiazhuang 050011, Hebei Province, China
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Pu N, Gao S, Xu Y, Zhao G, Lv Y, Nuerxiati A, Li JA, Wang D, Xu X, Kuang T, Wang X, Lou W, Liu L, Wu W. Alkaline Phosphatase-To-Albumin Ratio as a Prognostic Indicator in Pancreatic Ductal Adenocarcinoma after Curative Resection. J Cancer 2017; 8:3362-3370. [PMID: 29158809 PMCID: PMC5665053 DOI: 10.7150/jca.20917] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/31/2017] [Indexed: 12/26/2022] Open
Abstract
Background: The prognosis of pancreatic ductal adenocarcinoma (PDAC) remains poor and the models for survival prediction in PDAC patients after curative resection are still limited. Preoperative alkaline phosphatase-to-albumin ratio (APAR), an original inflammation-based score, has been established to analyze the prognostic significance in PDAC. Therefore, in this study, we aim to formulate a valuable prognostic nomogram for PDAC following curative resection. Methods: A total of 354 patients with PDAC undergoing curative resection were retrospectively enrolled in this study. The prognostic value of APAR was analyzed in primary cohort containing 220 randomly selected PDAC patients with curative resection and prognostic nomogram incorporating APAR into the American Joint Commission on Cancer (AJCC) 8th edition was established to obtain superior discriminatory abilities. The predictive performance of APAR was further validated in another independent cohort of 134 PDAC patients. Results: Patients with higher serum APAR level were probable to sustain poorer overall survival (OS). Significant positive correlations were found between APAR and tumor site, and several serum biochemical indexes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), etc. The results of multivariate analysis showed, APAR was also identified as an independent prognostic indicator for OS in both primary and validation cohorts (P=0.004, P=0.038, respectively). Compared with the AJCC 8th edition, the nomogram consisting of APAR, pathological differentiation and the TNM staging system of AJCC 8th edition showed superior predictive accuracy for OS. All these results were further verified in the validation cohort. Conclusions: APAR can be considered as a novel independent prognostic biomarker for PDAC following curative resection. One more accurate and advanced predictive model will be achieved via the incorporation of APAR into nomogram.
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Affiliation(s)
- Ning Pu
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Shanshan Gao
- Department of Interventional Radiology, Zhongshan Hospital and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, People's Republic of China
| | - Yadong Xu
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Guochao Zhao
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Yang Lv
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Abulimiti Nuerxiati
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jian-Ang Li
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Dansong Wang
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Xuefeng Xu
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Tiantao Kuang
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Xiaolin Wang
- Department of Interventional Radiology, Zhongshan Hospital and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, People's Republic of China
| | - Wenhui Lou
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Lingxiao Liu
- Department of Interventional Radiology, Zhongshan Hospital and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, People's Republic of China
| | - Wenchuan Wu
- Department of General Surgery, Zhongshan Hospital, Institute of General Surgery and Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
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16
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Wang J, Liu Y, Zhang N, Li X, Xin P, Bi J, Kong C. Prognostic role of pretreatment platelet to lymphocyte ratio in urologic cancer. Oncotarget 2017; 8:70874-70882. [PMID: 29050328 PMCID: PMC5642603 DOI: 10.18632/oncotarget.20147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/23/2017] [Indexed: 12/12/2022] Open
Abstract
The prognostic value of platelet to lymphocyte ratio (PLR) in urologic cancer does not reach a consensus. Herein, we performed the meta-analysis to determine the prognostic role of PLR in patients with urologic cancer. A literature search was performed in the PubMed, Embase, and Web of Science databases. Hazard ratios (HRs) were extracted to estimate the association between PLR and prognosis. A total of 20 articles comprising 6079 patients were included in this study. The pooled results showed that a high PLR was significantly associated with worse prognosis of overall survival (OS) in urologic cancer [HR=1.65, 95% confidence interval (CI) =1.37-1.99, P<0.01]. The result also indicated that an elevated PLR was significantly associated with poor OS in renal cancer (HR=1.88, 95% CI=1.39-2.55, P<0.01). In addition, the significant association between poor OS and elevated PLR in renal cancer was consistent regardless of treatment, cut-off value, sample size and study quality. Our result also indicated that an elevated PLR predicted shorter OS (HR=1.78, 95% CI=1.38-2.30, P<0.01) and cancer-specific survival (HR=2.02, 95% CI=1.24-3.29, P<0.01) in prostate cancer. In conclusion, an elevated PLR was a predictive indicator of poor survival in renal cancer and prostate cancer.
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Affiliation(s)
- Jianfeng Wang
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Yang Liu
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Naiwen Zhang
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Xuejie Li
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Peng Xin
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Jianbin Bi
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
| | - Chuize Kong
- Department of Urology, The First Hospital of China Medical University, Shenyang 110001, P.R. China
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Han JH, Yoon YE, Kim SY, Cho YI, Rha KH, Choi YD, Han WK. Preoperative Lymphocyte-Monocyte Ratio Ameliorates the Accuracy of Differential Diagnosis in Non-Metastatic Infiltrative Renal Masses. Yonsei Med J 2017; 58:388-394. [PMID: 28120570 PMCID: PMC5290019 DOI: 10.3349/ymj.2017.58.2.388] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/18/2016] [Accepted: 10/15/2016] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Distinguishing infiltrative renal cell carcinoma (RCC) from transitional cell carcinoma (TCC) is a challenging issue due to their radiologic similarities. We evaluated systemic inflammatory biomarkers as parameters for distinguishing tumor types. MATERIALS AND METHODS A computerized search of medical records from November 2005 to October 2015 identified 116 patients with infiltrative renal masses who were difficult to diagnose confirmatively in radiological study. We investigated the diagnostic efficacy among these patients with their preoperative absolute neutrophil counts (ANC), absolute lymphocyte counts (ALC), absolute monocyte counts (AMC), neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). RESULTS The infiltrative RCC group demonstrated significantly lower ALC {1449/μL (1140-1896), median [interquartile range (IQR)]} than the TCC group [1860/μL (1433-2342), p=0.016]. LMR [median (IQR)] also was lower in the infiltrative RCC group [2.98 (2.32-4.14) vs. TCC group 4.10 (2.86-6.09); p=0.011]. In subgroup analysis, non-metastatic infiltrative RCC showed lower ALC and LMR and higher NLR than non-metastatic TCC. Within non-metastatic infiltrative renal masses, multivariate logistic regression analysis revealed that younger patient age and lower LMR were associated with infiltrative RCC [odds ratios (OR) 0.874, p=0.024 and OR 0.461, p=0.048, respectively]. Receiver operating characteristic curve analysis showed that younger age and lower LMR were highly predictive of non-metastatic RCC (area under the curve=0.919, p<0.001). CONCLUSION Age and LMR were significantly different between patients with infiltrative renal mass. These are potential markers for distinguishing between infiltrative RCC and TCC without metastasis.
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Affiliation(s)
- Jang Hee Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Eun Yoon
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sook Young Kim
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young In Cho
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Koon Ho Rha
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Woong Kyu Han
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
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18
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The prognostic value of the neutrophil-lymphocyte ratio in renal oncology: A review. Urol Oncol 2017; 35:135-141. [PMID: 28233671 DOI: 10.1016/j.urolonc.2017.01.016] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/26/2016] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND The neutrophil-lymphocyte ratio (NLR) is a biological marker of inflammation with a significant prognostic value in the field of oncology. AIM In this review, we discuss the prognostic value of the NLR in renal cell carcinoma (RCC). MATERIAL AND METHOD We conducted a literature review of the PubMed database in August 2016. Initial research identified 31 publications. Following full-text screening, 15 studies were finally included: 7 studies concerning metastatic or locally advanced renal cancer, 6 studies dealing with localized renal cancer, 2 articles evaluating the NLR in renal cancer whatever the status of the disease (metastatic or localized). RESULTS For localized RCC, an NLR o 3 was predictive of a reduced risk of recurrence (hazard ratio ¼ 1.63 [1.15, 2.29]). The prognostic value of the NLR was stronger for metastatic or locally advanced RCC. An NLR o 3 predicted increased overall survival (hazard ratio ¼ 1.55 [1.36, 1.76]), progression-free survivals (hazard ratio ¼ 3.19 [2.23, 4.57]), and a response to systemic treatment. CONCLUSION In current practice, the NLR is a simple and inexpensive prognostic factor with potential improvement in the prognostic performance of nomograms used in renal oncology.
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19
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Sidana A, Kadakia M, Friend JC, Krane LS, Su D, Merino MJ, Srinivasan R. Determinants and prognostic implications of malignant ascites in metastatic papillary renal cancer. Urol Oncol 2016; 35:114.e9-114.e14. [PMID: 27914873 DOI: 10.1016/j.urolonc.2016.10.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/21/2016] [Accepted: 10/31/2016] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To describe the incidence of ascites in metastatic papillary renal cell cancer (pRCC), identify the factors associated with its development and evaluate its prognostic effect on the survival of these patients. METHODS A retrospective evaluation of the medical records of patients with metastatic pRCC seen at National Cancer Institute (2000-2014) was undertaken. Logistic regression to identify predictors of the development of malignant ascites and Kaplan-Meier analysis to estimate survival was done. RESULTS Overall, 106 consecutive patients with metastatic pRCC were identified; sufficient data were available in 100 patients to enable assessment of ascites. Further, 20% had evidence of malignant ascites. Median age at diagnosis of ascites was 48.0 years (26.1-76.6 years) and median time to development of ascites from initial diagnosis of metastatic disease was 16.0 (0-73.3) months. There was no significant difference in the incidence of ascites between patients with hereditary and sporadic pRCC (P = 0.803) or among patients with different subtypes of pRCC (P = 0.456). Elevated platelet-lymphocyte ratio predicted development of malignant ascites in our cohort (P = 0.009). Median overall survival was shorter for patients who developed ascites [25.0 (10.2-39.8) months] compared with patients who did not develop this complication [42.5 (30.5-54.4) months, P = 0.041]. CONCLUSION To our knowledge, this is the first systematic evaluation of the incidence, predictors, and prognostic effect of ascites in metastatic pRCC. Malignant ascites is a common manifestation of metastatic pRCC and is associated with a shorter overall survival. An elevated platelet-lymphocyte ratio predicts a higher risk of developing malignant ascites.
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Affiliation(s)
- Abhinav Sidana
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD.
| | - Meet Kadakia
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Julia C Friend
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Louis S Krane
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Daniel Su
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Maria J Merino
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD
| | - Ramaprasad Srinivasan
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
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20
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Park TJ, Cho YH, Chung HS, Hwang EC, Jung SH, Hwang JE, Bae WK, Kim JW, Heo SH, Hur YH, Jung SI, Kwon DD. Prognostic significance of platelet-lymphocyte ratio in patients receiving first-line tyrosine kinase inhibitors for metastatic renal cell cancer. SPRINGERPLUS 2016; 5:1889. [PMID: 27843746 PMCID: PMC5084140 DOI: 10.1186/s40064-016-3592-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/21/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND The platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) have been reported as prognostic factors in various cancers, but their roles in metastatic renal cell cancer (mRCC) remain unclear. We investigated the significance of PLR and NLR, along with that of established prognostic factors, in mRCC patients receiving first-line tyrosine kinase inhibitors (TKI). METHODS Data obtained from 63 mRCC patients who received first-line TKI between 2007 and 2013 were evaluated retrospectively. The association of PLR, NLR, and established prognostic factors with progression-free survival (PFS) and overall survival (OS) was analyzed using the Kaplan-Meier method. The influence of independent prognostic factors on survival was determined using multivariable Cox regression analysis. RESULTS High NLR (>3.6) and PLR (>150) were related to shorter PFS (p = 0.001) and OS (p = 0.001). The presence of brain metastases [hazard ratio (HR) 4.94, 95% CI 1.75-13.9; p = 0.002] and high PLR (>150, HR 13.1, 95% CI 5.14-33.2; p = 0.001) were independently associated with PFS, and Eastern Cooperative Oncology Group Performance status ≥2 (HR 3.60, 95% CI 1.39-9.31; p = 0.008), lymph node metastasis (HR 2.76, 95% CI 1.11-6.86; p = 0.029), brain metastasis (HR 9.39, 95% CI 2.74-32.1; p = 0.001), and high PLR (>150, HR 16.1, 95% CI 4.41-58.4; p = 0.001) with OS. CONCLUSIONS High PLR was associated with shorter survival of mRCC patients receiving first-line TKI. The PLR may be an effective independent prognostic factor in this setting.
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Affiliation(s)
- Tae Ju Park
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Yang Hyun Cho
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Sung-Hoon Jung
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jun Eul Hwang
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Woo Kyun Bae
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jin Woong Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young Hoe Hur
- Department of Hepato-Pancreato-Biliary Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
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Ozgonul C, Sertoglu E, Mumcuoglu T, Ozge G, Gokce G. Prediction of Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma by Using Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio. Ocul Immunol Inflamm 2015; 24:665-670. [PMID: 26645794 DOI: 10.3109/09273948.2015.1063671] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess the levels of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in patients with pseudoexfoliation syndrome (PEX) and to compare the NLR and PLR results of patients with PEX, PEX glaucoma (PXG), and healthy controls. METHODS In total, 34 patients with PEX, 29 patients with PXG, and 42 healthy subjects were enrolled in this retrospective study. Complete ophthalmologic examination and complete blood count measurements were performed of all subjects. Complete blood counts were performed within 2 h of blood collection. RESULTS There was a significant difference in NLR between PEX and control groups (p = 0.012) and PXG and control groups (p = 0.003). Also, a significant difference was found in PLR values between control and PXG groups (p = 0.024). CONCLUSIONS Our study for the first time provides evidence that PLR and NLR may be useful for predicting the prognosis of PEX patients and progression to PXG.
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Affiliation(s)
- Cem Ozgonul
- a Van Military Hospital , Department of Ophthalmology , Van , Turkey
| | - Erdim Sertoglu
- b Ankara Mevki Military Hospital, Anittepe Dispensary , Biochemistry Laboratory , Ankara , Turkey
| | - Tarkan Mumcuoglu
- c Gulhane Military Medical Academy , Department of Ophthalmology , Ankara , Turkey
| | - Gokhan Ozge
- c Gulhane Military Medical Academy , Department of Ophthalmology , Ankara , Turkey
| | - Gokcen Gokce
- d Kayseri Military Hospital , Department of Ophthalmology , Kayseri , Turkey
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Linsley PS, Chaussabel D, Speake C. The Relationship of Immune Cell Signatures to Patient Survival Varies within and between Tumor Types. PLoS One 2015; 10:e0138726. [PMID: 26398410 PMCID: PMC4580625 DOI: 10.1371/journal.pone.0138726] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/02/2015] [Indexed: 12/27/2022] Open
Abstract
Enhancing pre-existing anti-tumor immunity leads to therapeutic benefit for some patients, but why some tumors are more immunogenic than others remains unresolved. We took a unique systems approach to relate patient survival to immune gene expression in >3,500 tumor RNAseq profiles from a dozen tumor types. We found significant links between immune gene expression and patient survival in 8/12 tumor types, with tumors partitioned by gene expression comprising distinct molecular subtypes. T/NK cell genes were most clearly survival-related for melanoma, head and neck, and bladder tumors, whereas myeloid cell genes were most clearly survival-related with kidney and breast tumors. T/NK or myeloid cell gene expression was linked to poor prognosis in bladder and kidney tumors, respectively, suggesting tumor-specific immunosuppressive checkpoints. Our results suggest new biomarkers for existing cancer immunotherapies and identify targets for new immunotherapies.
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Affiliation(s)
- Peter S. Linsley
- Department of Systems Immunology, Benaroya Research Institute, 1201 Ninth Avenue, Seattle, WA 98101–2795, United States of America
- * E-mail:
| | - Damien Chaussabel
- Department of Systems Immunology, Benaroya Research Institute, 1201 Ninth Avenue, Seattle, WA 98101–2795, United States of America
| | - Cate Speake
- Department of Systems Immunology, Benaroya Research Institute, 1201 Ninth Avenue, Seattle, WA 98101–2795, United States of America
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