Clinical variables for predicting metastatic renal cell carcinoma patients who might not benefit from cytoreductive nephrectomy: neutrophil-to-lymphocyte ratio and performance status

Ohno, Yoshio; Nakashima, Jun; Ohori, Makoto; Tanaka, Ayako; Hashimoto, Takeshi; Gondo, Tatsuo; Hatano, Tadashi; Tachibana, Masaaki

doi:10.1007/s10147-012-0514-5

Cited by 53 publications

(45 citation statements)

References 26 publications

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“…In contrast to recently published articles, our univariate analysis did not demonstrate the independent prognostic value of NLR; [13][14][15][16][17][18] perhaps this is because only 24% of our study population had an elevated NLR. This finding should be confirmed with a much larger cohort of patients.…”

Section: Knowledge Itcontrasting

confidence: 55%

A simple prognostic model for overall survival in metastatic renal cell carcinoma

Assi

Patenaude

Toumishey

et al. 2016

CUAJ

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Introduction: The primary purpose of this study was to develop a simpler prognostic model to predict overall survival for patients treated for metastatic renal cell carcinoma (mRCC) by examining variables shown in the literature to be associated with survival. Methods: We conducted a retrospective analysis of patients treated for mRCC at two Canadian centres. All patients who started first-line treatment were included in the analysis. A multivariate Cox proportional hazards regression model was constructed using a stepwise procedure. Patients were assigned to risk groups depending on how many of the three risk factors from the final multivariate model they had. Results: There were three risk factors in the final multivariate model: hemoglobin, prior nephrectomy, and time from diagnosis to treatment. Patients in the high-risk group (two or three risk factors) had a median survival of 5.9 months, while those in the intermediate-risk group (one risk factor) had a median survival of 16.2 months, and those in the low-risk group (no risk factors) had a median survival of 50.6 months. Conclusions: In multivariate analysis, shorter survival times were associated with hemoglobin below the lower limit of normal, absence of prior nephrectomy, and initiation of treatment within one year of diagnosis. IntroductionRenal cell carcinoma (RCC) is an aggressive disease, recurring in up to 40% of patients who are initially treated for a localized tumour.1 About one-third of patients with RCC have metastatic disease at diagnosis.2,3 Advances in our understanding of the biology of RCC and particularly the role of angiogenesis in the progress of the clear cell subtype have led to the development of oral tyrosine kinase inhibitors with activity mostly against vascular endothelial growth factor receptor 2 (VEGF-2). These novel targeted therapies have transformed the management of metastatic RCC (mRCC). 4,5 More than 80% of patients achieve clinical benefit in the form of objective response to treatment or disease stabilization with tyrosine kinase inhibitors. Additionally, median overall survival with the targeted therapies is now greater than two years, which is more than double the overall survival seen in the interferon-α era.

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Section: Knowledge Itcontrasting

confidence: 55%

A simple prognostic model for overall survival in metastatic renal cell carcinoma

Assi

Patenaude

Toumishey

et al. 2016

CUAJ

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“…Further retrospective data showed than CN was [25]. Together, these retrospective data suggest that CN might have a role in some well-selected individuals [26]. In the present study, we demonstrated that only patients with ECOG score of 0 to 1 or good/intermediate MSKCC prognostic score had a benefit from CN.…”

Section: Discussionmentioning

confidence: 56%

Nephrectomy improves overall survival in patients with metastatic renal cell carcinoma in cases of favorable MSKCC or ECOG prognostic features

Mathiéu

Pignot

Ingles

et al. 2015

Urologic Oncology: Seminars and Original Investigations

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“…Some of these factors, such as performance status [23] , haemoglobin levels [24] , LDH and albumin [25,26] have also shown to have a predictive value of survival in patients who underwent CN for mRCC in other studies. An interesting study from Rausch et al [27] showed that CRP levels could also be helpful in selecting mRCC patients likely to benefit from metastasectomy.…”

Section: Discussionmentioning

confidence: 99%

Preoperative C-Reactive Protein Values as a Potential Component in Outcome Prediction Models of Metastasized Renal Cell Carcinoma Patients Receiving Cytoreductive Nephrectomy

Kalogirou

Mulfinger²,

Sokolakis³

et al. 2017

Urol Int

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Purpose: To validate preoperative C-reactive protein (CRP) levels as a prognostic marker for survival in a metastasized renal cell carcinoma (mRCC) patient cohort receiving cytoreductive nephrectomy (CN). Patients and Methods: By chart review, 146 mRCC patients receiving CN at our tertiary referral centre from 1997 to 2015 were identified retrospectively. All relevant clinicopathological features including laboratory parameters were collected and correlated to overall survival, progression-free survival and cancer-specific survival (CSS). The mean follow-up was 23 months (range 1-168 months). Results: Besides the already established scoring systems like the MSKCC criteria, an elevated preoperative CRP level (≥0.5 mg/dL) was an independent predictor of CSS in our study group including the chosen postoperative adjuvant therapies (TKI vs. immunotherapy vs. others). With regard to morbidity, patients with a good performance status, small tumour size and adequate renal function/haematopoiesis experienced less complication rates, thereby profiting more from CN. Conclusions: Our data provide indication that preoperative CRP levels should be implemented in nomograms regarding the outcome prediction in mRCC to identify candidates likely to profit from CN.

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Clinical variables for predicting metastatic renal cell carcinoma patients who might not benefit from cytoreductive nephrectomy: neutrophil-to-lymphocyte ratio and performance status

Abstract: Preoperative NLR elevation is significantly associated with poor outcomes in patients with metastatic RCC who underwent CN. Patients with NLR ≥4.0 and ECOG-PS ≥ 1 might not benefit from immediate CN after initial diagnosis.

Cited by 53 publications

References 26 publications

A simple prognostic model for overall survival in metastatic renal cell carcinoma

A simple prognostic model for overall survival in metastatic renal cell carcinoma

Nephrectomy improves overall survival in patients with metastatic renal cell carcinoma in cases of favorable MSKCC or ECOG prognostic features

Preoperative C-Reactive Protein Values as a Potential Component in Outcome Prediction Models of Metastasized Renal Cell Carcinoma Patients Receiving Cytoreductive Nephrectomy

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