Impact of the neutrophil-to-lymphocyte ratio as a surgical prognostic factor in renal cell carcinoma with inferior-vena-cava tumor thrombus

Nagamoto, Shoichi; Urakami, Shinji; Oka, Suguru; Ogawa, Kohei; Kono, Kei; Sakaguchi, Kazushige; Kinowaki, Keiichi; Yamada, Daisuke; Kume, Haruki

doi:10.1016/j.asjsur.2022.03.023

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…Specifically, greater NLR correlates with worse outcomes in both non-metastatic and metastatic RCC. 11,12,[20][21][22] While most of these studies do not focus on RCC with a tumor thrombus, two recent papers have. Nagamoto et al 11 looked at patients with RCC and an IVC thrombus and concluded that a NLR ⩾ 2.9 was an independent predictor of poor 5-year cancer-specific survival and overall survival.…”

Section: Discussionmentioning

confidence: 99%

“…11,12,[20][21][22] While most of these studies do not focus on RCC with a tumor thrombus, two recent papers have. Nagamoto et al 11 looked at patients with RCC and an IVC thrombus and concluded that a NLR ⩾ 2.9 was an independent predictor of poor 5-year cancer-specific survival and overall survival. Peyton et al 12 also had similar conclusions in their study, finding that elevated NLR and absolute neutrophil counts correlated to worse overall survival.…”

Section: Discussionmentioning

confidence: 99%

“…9 Despite compelling findings, most current papers either exclude patients with RCC and a tumor thrombus or have a lack of cases included in their analysis, and so there is a paucity of literature examining the role of immune cell markers on long-term outcomes after nephrectomy with thrombectomy for RCC. 11,12 Studies that do exist do not incorporate patients from a diverse range of backgrounds into their analysis. Moreover, there is evidence that RCC patients with a tumor thrombus have unique genetic properties and thus can be treated separately from RCC patients without a tumor thrombus.…”

Section: Introductionmentioning

confidence: 99%

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The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

Sandberg,

Namugosa,

Ritts

et al. 2024

Urologia

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Introduction: The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy. Methods: Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples t-test, Pearson’s bivariate correlation, and analysis of variance. Results: One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; p < 0.001). Patients with tumor pathology showing perirenal fat invasion had a greater neutrophil count compared to those who did not (7.5 vs 5.5; p = 0.010). Patients with metastatic RCC had a lower LMR compared to those without metastases after surgery (2.5 vs 3.2; p = 0.041). Tumor size, both preoperatively and on gross specimen, had an interaction with multiple immune cell metrics ( p < 0.05). Conclusions: Preoperative immune metrics have clinical utility in predicting cancer-specific outcomes for patients with RCC and a tumor thrombus. Additional study is needed to determine the added value of preoperative serum immune cell data to established prognostic risk calculators for this patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

Sandberg,

Namugosa,

Ritts

et al. 2024

Urologia

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“…In line with nomograms and prediction models in metastasized RCC [ 27 , 28 ], researchers have also investigated the prognostic role of blood counts in RCC cases with tumor thrombus. Specifically, serum gamma-glutamyltransferase (GGT) [ 29 ], as well as neutrophil-to-lymphocyte ratio [ 30 , 31 ] and lymphocyte-to-monocyte ratio [ 32 ], were reported to significantly predict survival in patients suffering from RCC with tumor thrombus.…”

Section: Discussionmentioning

confidence: 99%

Critical Evaluation of a microRNA-Based Risk Classifier Predicting Cancer-Specific Survival in Renal Cell Carcinoma with Tumor Thrombus of the Inferior Vena Cava

Kotlyar

Krebs

Solimando

et al. 2023

Cancers

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(1) Background: Clear cell renal cell carcinoma extending into the inferior vena cava (ccRCCIVC) represents a clinical high-risk setting. However, there is substantial heterogeneity within this patient subgroup regarding survival outcomes. Previously, members of our group developed a microRNA(miR)-based risk classifier—containing miR-21-5p, miR-126-3p and miR-221-3p expression—which significantly predicted the cancer-specific survival (CSS) of ccRCCIVC patients. (2) Methods: Examining a single-center cohort of tumor tissue from n = 56 patients with ccRCCIVC, we measured the expression levels of miR-21, miR-126, and miR-221 using qRT-PCR. The prognostic impact of clinicopathological parameters and miR expression were investigated via single-variable and multivariable Cox regression. Referring to the previously established risk classifier, we performed Kaplan–Meier analyses for single miR expression levels and the combined risk classifier. Cut-off values and weights within the risk classifier were taken from the previous study. (3) Results: miR-21 and miR-126 expression were significantly associated with lymphonodal status at the time of surgery, the development of metastasis during follow-up, and cancer-related death. In Kaplan–Meier analyses, miR-21 and miR-126 significantly impacted CSS in our cohort. Moreover, applying the miR-based risk classifier significantly stratified ccRCCIVC according to CSS. (4) Conclusions: In our retrospective analysis, we successfully validated the miR-based risk classifier within an independent ccRCCIVC cohort.

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Prognostic value of preoperative radiographic perinephric fat features in renal cell carcinoma patients undergoing surgery

Kuo,

Lee,

Wang

et al. 2024

Asian Journal of Surgery

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Impact of the neutrophil-to-lymphocyte ratio as a surgical prognostic factor in renal cell carcinoma with inferior-vena-cava tumor thrombus

Cited by 3 publications

References 20 publications

The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus

Critical Evaluation of a microRNA-Based Risk Classifier Predicting Cancer-Specific Survival in Renal Cell Carcinoma with Tumor Thrombus of the Inferior Vena Cava

Prognostic value of preoperative radiographic perinephric fat features in renal cell carcinoma patients undergoing surgery

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