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


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


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


CONCLUSIONS
Pretreatment NLR may be an independent prognostic factor for mRCC patients who are receiving targeted therapy.
Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong'an Rd, Shanghai, 200032, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Gui-Ming
GM
Zhang
Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong'an Rd, Shanghai, 200032, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Yao
Y
Zhu
Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong'an Rd, Shanghai, 200032, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Wei-Jie
WJ
Gu
Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong'an Rd, Shanghai, 200032, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Hai-Liang
HL
Zhang
Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong'an Rd, Shanghai, 200032, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
Guo-Hai
GH
Shi
Department of Urology, Fudan University, Shanghai Cancer Center, No. 270, Dong'an Rd, Shanghai, 200032, People's Republic of China. yedingwei1963@126.com.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. yedingwei1963@126.com.
Ding-Wei
DW
Ye
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000556:secondary*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology*; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors*; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
D000970:Antineoplastic Agents; D009363:Neoplasm Proteins
Metastasis; Neutrophil-to-lymphocyte ratio; Prognosis; Renal cell carcinoma; Targeted therapy