title: Prognostic significance of platelet-lymphocyte ratio in patients receiving first-line tyrosine kinase inhibitors for metastatic renal cell cancer.
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.
authors.affiliation: Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea.
authors.forename: Tae Ju
authors.initials: TJ
authors.lastname: Park
authors.affiliation: Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea.
authors.forename: Yang Hyun
authors.initials: YH
authors.lastname: Cho
authors.affiliation: Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea.
authors.forename: Ho Seok
authors.initials: HS
authors.lastname: Chung
authors.affiliation: Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea.
authors.forename: Eu Chang
authors.identifier: 0000-0002-2031-124X
authors.initials: EC
authors.lastname: Hwang
authors.affiliation: Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Jung
authors.affiliation: Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Jun Eul
authors.initials: JE
authors.lastname: Hwang
authors.affiliation: Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Woo Kyun
authors.initials: WK
authors.lastname: Bae
authors.affiliation: Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Jin Woong
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Suk Hee
authors.initials: SH
authors.lastname: Heo
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Young Hoe
authors.initials: YH
authors.lastname: Hur
authors.affiliation: Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea.
authors.forename: Seung Il
authors.initials: SI
authors.lastname: Jung
authors.affiliation: Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea.
authors.forename: Dong Deuk
authors.initials: DD
authors.lastname: Kwon
keywords: Carcinoma, renal cell; Neoplasm metastasis; Neutrophil–lymphocyte ratio; Platelet–lymphocyte ratio