Validation of the pre-treatment neutrophil–lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients
Background: The neutrophil–lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammatory response. Several studies suggest a negative impact of increased NLR for patient’s survival in different types of cancer. However, previous findings from small-scale studies revealed conflict...
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| Veröffentlicht in: | British journal of cancer 2013-03, Vol.108 (4), p.901-907 |
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| creator | Pichler, M Hutterer, G C Stoeckigt, C Chromecki, T F Stojakovic, T Golbeck, S Eberhard, K Gerger, A Mannweiler, S Pummer, K Zigeuner, R |
| description | Background:
The neutrophil–lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammatory response. Several studies suggest a negative impact of increased NLR for patient’s survival in different types of cancer. However, previous findings from small-scale studies revealed conflicting results about its prognostic significance with regard to different clinical end points in non-metastatic renal cell carcinoma (RCC) patients. Therefore, the aim of our study was the validation of the prognostic significance of NLR in a large cohort of RCC patients.
Methods:
Data from 678 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single centre, were evaluated retrospectively. Cancer-specific, metastasis-free, as well as overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of NLR, multivariate Cox regression models were applied for all three different end points. Influence of the NLR on the predictive accuracy of the Leibovich prognosis score was determined by Harrell's concordance index.
Results:
Multivariate analysis identified increased NLR as an independent prognostic factor for overall (hazard ratio (HR)=1.59, 95% confidence interval (CI)=1.10–2.31,
P
=0.014), but not for cancer-specific (HR=1.59, 95% CI=0.84–2.99,
P
=0.148), nor for metastasis-free survival (HR=1.39, 95% CI=0.85–2.28,
P
=0.184). The estimated concordance index was 0.79 using the Leibovich risk score and 0.81 when NLR was added.
Conclusion:
Regarding patients’ OS, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. Adding the NLR to well-established prognostic models such as the Leibovich prognosis score might improve their predictive ability. |
| doi_str_mv | 10.1038/bjc.2013.28 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3590665</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1315134978</sourcerecordid><originalsourceid>FETCH-LOGICAL-c575t-863c5514a9663a8311fd7c8a5bc65df8734ecc994bbcf584cad256f2b5f486473</originalsourceid><addsrcrecordid>eNqNkk-L1DAYxoso7rh68i4BEYS1Y9I0f3oRZNlVYcGLeg1v03SaoU3GJF2Ymx9B8Bv6SUydcV3Fg5eEJL_3ed43PEXxmOA1wVS-bLd6XWFC15W8U6wIo1VJZCXuFiuMsShxU-GT4kGM23xssBT3i5OKUslEJVfF108w2g6S9Q75HqXBoF0wZQoG0mRcQs7MKfjdYMfvX76N-2k3eL1PBoWlBkFEkAv8xvmYrEY96OQDsi5fjxA2Bl3MudqAQ9oPPqTFJBgHI9JmzAsEbZ2fskjWy37xYXGvhzGaR8f9tPh4efHh_G159f7Nu_PXV6VmgqVScqoZIzU0nFOQlJC-E1oCazVnXS8FrY3WTVO3re6ZrDV0FeN91bK-lrwW9LR4ddDdze1kOp29A4xqF-wEYa88WPXni7OD2vhrRVmDOWdZ4PlRIPjPs4lJTTYuQ4Ezfo6KUCJ5w4ik_4MyQutGyIw-_Qvd-jnk__pJ1RILKepMnR0oHXyMwfQ3fROsllCoHAq1hEJVi-aT26PesL9SkIFnRwCihrEP4LSNvzlBcM3ZMvKLAxfzk9uYcKu5f_j-AJ9u0d4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1314807874</pqid></control><display><type>article</type><title>Validation of the pre-treatment neutrophil–lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients</title><source>MEDLINE</source><source>Nature</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Pichler, M ; Hutterer, G C ; Stoeckigt, C ; Chromecki, T F ; Stojakovic, T ; Golbeck, S ; Eberhard, K ; Gerger, A ; Mannweiler, S ; Pummer, K ; Zigeuner, R</creator><creatorcontrib>Pichler, M ; Hutterer, G C ; Stoeckigt, C ; Chromecki, T F ; Stojakovic, T ; Golbeck, S ; Eberhard, K ; Gerger, A ; Mannweiler, S ; Pummer, K ; Zigeuner, R</creatorcontrib><description>Background:
The neutrophil–lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammatory response. Several studies suggest a negative impact of increased NLR for patient’s survival in different types of cancer. However, previous findings from small-scale studies revealed conflicting results about its prognostic significance with regard to different clinical end points in non-metastatic renal cell carcinoma (RCC) patients. Therefore, the aim of our study was the validation of the prognostic significance of NLR in a large cohort of RCC patients.
Methods:
Data from 678 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single centre, were evaluated retrospectively. Cancer-specific, metastasis-free, as well as overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of NLR, multivariate Cox regression models were applied for all three different end points. Influence of the NLR on the predictive accuracy of the Leibovich prognosis score was determined by Harrell's concordance index.
Results:
Multivariate analysis identified increased NLR as an independent prognostic factor for overall (hazard ratio (HR)=1.59, 95% confidence interval (CI)=1.10–2.31,
P
=0.014), but not for cancer-specific (HR=1.59, 95% CI=0.84–2.99,
P
=0.148), nor for metastasis-free survival (HR=1.39, 95% CI=0.85–2.28,
P
=0.184). The estimated concordance index was 0.79 using the Leibovich risk score and 0.81 when NLR was added.
Conclusion:
Regarding patients’ OS, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. Adding the NLR to well-established prognostic models such as the Leibovich prognosis score might improve their predictive ability.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/bjc.2013.28</identifier><identifier>PMID: 23385728</identifier><identifier>CODEN: BJCAAI</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/53/2422 ; 692/699/67/589/1588/1351 ; 692/700/1750 ; Aged ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Blood Cell Count ; Cancer Research ; Carcinoma, Renal Cell - blood ; Carcinoma, Renal Cell - mortality ; Cohort analysis ; Disease-Free Survival ; Drug Resistance ; Epidemiology ; Female ; Humans ; Kidney cancer ; Kidney Neoplasms - blood ; Kidney Neoplasms - mortality ; Kidneys ; Lymphocytes - cytology ; Male ; Medical prognosis ; Medical sciences ; Metastasis ; Middle Aged ; Molecular Diagnostics ; Molecular Medicine ; Multivariate Analysis ; Nephrology. Urinary tract diseases ; Neutrophils ; Neutrophils - cytology ; Oncology ; Pathology ; Prognosis ; Retrospective Studies ; Risk assessment ; Tumors ; Tumors of the urinary system ; Urology</subject><ispartof>British journal of cancer, 2013-03, Vol.108 (4), p.901-907</ispartof><rights>The Author(s) 2013</rights><rights>2014 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Mar 5, 2013</rights><rights>Copyright © 2013 Cancer Research UK 2013 Cancer Research UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c575t-863c5514a9663a8311fd7c8a5bc65df8734ecc994bbcf584cad256f2b5f486473</citedby><cites>FETCH-LOGICAL-c575t-863c5514a9663a8311fd7c8a5bc65df8734ecc994bbcf584cad256f2b5f486473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590665/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590665/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27104655$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23385728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pichler, M</creatorcontrib><creatorcontrib>Hutterer, G C</creatorcontrib><creatorcontrib>Stoeckigt, C</creatorcontrib><creatorcontrib>Chromecki, T F</creatorcontrib><creatorcontrib>Stojakovic, T</creatorcontrib><creatorcontrib>Golbeck, S</creatorcontrib><creatorcontrib>Eberhard, K</creatorcontrib><creatorcontrib>Gerger, A</creatorcontrib><creatorcontrib>Mannweiler, S</creatorcontrib><creatorcontrib>Pummer, K</creatorcontrib><creatorcontrib>Zigeuner, R</creatorcontrib><title>Validation of the pre-treatment neutrophil–lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>Background:
The neutrophil–lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammatory response. Several studies suggest a negative impact of increased NLR for patient’s survival in different types of cancer. However, previous findings from small-scale studies revealed conflicting results about its prognostic significance with regard to different clinical end points in non-metastatic renal cell carcinoma (RCC) patients. Therefore, the aim of our study was the validation of the prognostic significance of NLR in a large cohort of RCC patients.
Methods:
Data from 678 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single centre, were evaluated retrospectively. Cancer-specific, metastasis-free, as well as overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of NLR, multivariate Cox regression models were applied for all three different end points. Influence of the NLR on the predictive accuracy of the Leibovich prognosis score was determined by Harrell's concordance index.
Results:
Multivariate analysis identified increased NLR as an independent prognostic factor for overall (hazard ratio (HR)=1.59, 95% confidence interval (CI)=1.10–2.31,
P
=0.014), but not for cancer-specific (HR=1.59, 95% CI=0.84–2.99,
P
=0.148), nor for metastasis-free survival (HR=1.39, 95% CI=0.85–2.28,
P
=0.184). The estimated concordance index was 0.79 using the Leibovich risk score and 0.81 when NLR was added.
Conclusion:
Regarding patients’ OS, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. Adding the NLR to well-established prognostic models such as the Leibovich prognosis score might improve their predictive ability.</description><subject>692/53/2422</subject><subject>692/699/67/589/1588/1351</subject><subject>692/700/1750</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Blood Cell Count</subject><subject>Cancer Research</subject><subject>Carcinoma, Renal Cell - blood</subject><subject>Carcinoma, Renal Cell - mortality</subject><subject>Cohort analysis</subject><subject>Disease-Free Survival</subject><subject>Drug Resistance</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney cancer</subject><subject>Kidney Neoplasms - blood</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidneys</subject><subject>Lymphocytes - cytology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Molecular Diagnostics</subject><subject>Molecular Medicine</subject><subject>Multivariate Analysis</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Neutrophils</subject><subject>Neutrophils - cytology</subject><subject>Oncology</subject><subject>Pathology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk assessment</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urology</subject><issn>0007-0920</issn><issn>1532-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkk-L1DAYxoso7rh68i4BEYS1Y9I0f3oRZNlVYcGLeg1v03SaoU3GJF2Ymx9B8Bv6SUydcV3Fg5eEJL_3ed43PEXxmOA1wVS-bLd6XWFC15W8U6wIo1VJZCXuFiuMsShxU-GT4kGM23xssBT3i5OKUslEJVfF108w2g6S9Q75HqXBoF0wZQoG0mRcQs7MKfjdYMfvX76N-2k3eL1PBoWlBkFEkAv8xvmYrEY96OQDsi5fjxA2Bl3MudqAQ9oPPqTFJBgHI9JmzAsEbZ2fskjWy37xYXGvhzGaR8f9tPh4efHh_G159f7Nu_PXV6VmgqVScqoZIzU0nFOQlJC-E1oCazVnXS8FrY3WTVO3re6ZrDV0FeN91bK-lrwW9LR4ddDdze1kOp29A4xqF-wEYa88WPXni7OD2vhrRVmDOWdZ4PlRIPjPs4lJTTYuQ4Ezfo6KUCJ5w4ik_4MyQutGyIw-_Qvd-jnk__pJ1RILKepMnR0oHXyMwfQ3fROsllCoHAq1hEJVi-aT26PesL9SkIFnRwCihrEP4LSNvzlBcM3ZMvKLAxfzk9uYcKu5f_j-AJ9u0d4</recordid><startdate>20130305</startdate><enddate>20130305</enddate><creator>Pichler, M</creator><creator>Hutterer, G C</creator><creator>Stoeckigt, C</creator><creator>Chromecki, T F</creator><creator>Stojakovic, T</creator><creator>Golbeck, S</creator><creator>Eberhard, K</creator><creator>Gerger, A</creator><creator>Mannweiler, S</creator><creator>Pummer, K</creator><creator>Zigeuner, R</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7T5</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20130305</creationdate><title>Validation of the pre-treatment neutrophil–lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients</title><author>Pichler, M ; Hutterer, G C ; Stoeckigt, C ; Chromecki, T F ; Stojakovic, T ; Golbeck, S ; Eberhard, K ; Gerger, A ; Mannweiler, S ; Pummer, K ; Zigeuner, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c575t-863c5514a9663a8311fd7c8a5bc65df8734ecc994bbcf584cad256f2b5f486473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>692/53/2422</topic><topic>692/699/67/589/1588/1351</topic><topic>692/700/1750</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Blood Cell Count</topic><topic>Cancer Research</topic><topic>Carcinoma, Renal Cell - blood</topic><topic>Carcinoma, Renal Cell - mortality</topic><topic>Cohort analysis</topic><topic>Disease-Free Survival</topic><topic>Drug Resistance</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney cancer</topic><topic>Kidney Neoplasms - blood</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidneys</topic><topic>Lymphocytes - cytology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Molecular Diagnostics</topic><topic>Molecular Medicine</topic><topic>Multivariate Analysis</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Neutrophils</topic><topic>Neutrophils - cytology</topic><topic>Oncology</topic><topic>Pathology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk assessment</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pichler, M</creatorcontrib><creatorcontrib>Hutterer, G C</creatorcontrib><creatorcontrib>Stoeckigt, C</creatorcontrib><creatorcontrib>Chromecki, T F</creatorcontrib><creatorcontrib>Stojakovic, T</creatorcontrib><creatorcontrib>Golbeck, S</creatorcontrib><creatorcontrib>Eberhard, K</creatorcontrib><creatorcontrib>Gerger, A</creatorcontrib><creatorcontrib>Mannweiler, S</creatorcontrib><creatorcontrib>Pummer, K</creatorcontrib><creatorcontrib>Zigeuner, R</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pichler, M</au><au>Hutterer, G C</au><au>Stoeckigt, C</au><au>Chromecki, T F</au><au>Stojakovic, T</au><au>Golbeck, S</au><au>Eberhard, K</au><au>Gerger, A</au><au>Mannweiler, S</au><au>Pummer, K</au><au>Zigeuner, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Validation of the pre-treatment neutrophil–lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients</atitle><jtitle>British journal of cancer</jtitle><stitle>Br J Cancer</stitle><addtitle>Br J Cancer</addtitle><date>2013-03-05</date><risdate>2013</risdate><volume>108</volume><issue>4</issue><spage>901</spage><epage>907</epage><pages>901-907</pages><issn>0007-0920</issn><eissn>1532-1827</eissn><coden>BJCAAI</coden><abstract>Background:
The neutrophil–lymphocyte ratio (NLR) has been proposed as an indicator of systemic inflammatory response. Several studies suggest a negative impact of increased NLR for patient’s survival in different types of cancer. However, previous findings from small-scale studies revealed conflicting results about its prognostic significance with regard to different clinical end points in non-metastatic renal cell carcinoma (RCC) patients. Therefore, the aim of our study was the validation of the prognostic significance of NLR in a large cohort of RCC patients.
Methods:
Data from 678 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single centre, were evaluated retrospectively. Cancer-specific, metastasis-free, as well as overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the independent prognostic significance of NLR, multivariate Cox regression models were applied for all three different end points. Influence of the NLR on the predictive accuracy of the Leibovich prognosis score was determined by Harrell's concordance index.
Results:
Multivariate analysis identified increased NLR as an independent prognostic factor for overall (hazard ratio (HR)=1.59, 95% confidence interval (CI)=1.10–2.31,
P
=0.014), but not for cancer-specific (HR=1.59, 95% CI=0.84–2.99,
P
=0.148), nor for metastasis-free survival (HR=1.39, 95% CI=0.85–2.28,
P
=0.184). The estimated concordance index was 0.79 using the Leibovich risk score and 0.81 when NLR was added.
Conclusion:
Regarding patients’ OS, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. Adding the NLR to well-established prognostic models such as the Leibovich prognosis score might improve their predictive ability.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>23385728</pmid><doi>10.1038/bjc.2013.28</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 692/53/2422 692/699/67/589/1588/1351 692/700/1750 Aged Biological and medical sciences Biomedical and Life Sciences Biomedicine Blood Cell Count Cancer Research Carcinoma, Renal Cell - blood Carcinoma, Renal Cell - mortality Cohort analysis Disease-Free Survival Drug Resistance Epidemiology Female Humans Kidney cancer Kidney Neoplasms - blood Kidney Neoplasms - mortality Kidneys Lymphocytes - cytology Male Medical prognosis Medical sciences Metastasis Middle Aged Molecular Diagnostics Molecular Medicine Multivariate Analysis Nephrology. Urinary tract diseases Neutrophils Neutrophils - cytology Oncology Pathology Prognosis Retrospective Studies Risk assessment Tumors Tumors of the urinary system Urology |
| title | Validation of the pre-treatment neutrophil–lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients |
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