Meta-analysis of the efficacy of the pretreatment neutrophil-to-lymphocyte ratio as a predictor of prognosis in renal carcinoma patients receiving tyrosine kinase inhibitors

Abstract

The data on the impact of the neutrophil-to-lymphocyte ratio (NLR) in metastatic renal cell carcinoma (mRCC) patients receiving tyrosine kinase inhibitors (TKIs) are inconsistent. We therefore performed a meta-analysis to assess the prognostic value of pretreatment NLR in patients treated with TKIs for mRCC. We searched the Embase, Medline, PubMed, Cochrane and ISI Web of Knowledge to identify clinical studies that had evaluated the association between the pretreatment NLR and prognosis in mRCC patients. Prognostic outcomes included overall survival (OS) and progression-free survival (PFS). Nine studies encompassing a total of 1091 participants were included. We found that a high NLR was an effective prognostic marker of both OS (pooled HR: 1.93, 95% CI: 1.35-2.77; P = 0.0003) and PFS (pooled HR: 2.12, 95% CI: 1.42-3.17; P = 0.0002). Subgroup analysis revealed that studies reporting a NLR ≥ 3 showed a more significant effect of NLR on both OS (pooled HR: 2.50, 95% CI: 1.99-3.14; P = 0.0003) and PFS (pooled HR: 2.17, 95% CI: 1.26-3.75). This meta-analysis suggests that high pretreatment NLR is associated with a poor prognosis in mRCC patients receiving TKI treatment.

Prognostic role of the neutrophil-to-lymphocyte ratio (NLR) in patients with operable ampullary carcinoma

“…The prognostic significance of inflammatory factors such as albumin, CRC, and PLR has been demonstrated in numerous malignancies. The importance of NLR, as a readily accessible and cost-effective prognostic parameter, was also indicated in different types of cancers, including esophageal, colorectal, bladder, gastric, kidney, breast, lung, pancreatic, and gallbladder cancers, glioblastoma, cholangiocarcinoma, hepatocellular carcinoma, as well as in carcinoma of the ampulla of Vater [11][12][13][14][15][16][17][18][19][20][21][22][23]. Other prognostic parameters associated with survival of patients with ampullary carcinoma include T-stage, involvement of lymph nodes, surgical margin positivity, perineural invasion, lymphovascular invasion, ECOG performance score at the time of diagnosis, and tumor differentiation [24][25][26][27][28].…”

Prognostic significance of neutrophil-to-lymphocyte ratio in cervical cancer: A systematic review and meta-analysis of observational studies

“…Accumulating evidence demonstrates that NLR has prognostic significance in patients with various types of cancers [9–16]. Recently, several studies assessed the prognostic significance of NLR in patients with cervical cancer [17–25].…”

Current status of prognostic factors in patients with metastatic renal cell carcinoma

“…NLR has been shown to be associated with the prognosis of several solid malignant tumors . A meta‐analysis of patients with mRCC receiving TKI showed that high pretreatment NLR is associated with a poor prognosis . Several studies showed the impact of NLR for the prediction of survival benefit in patients undergoing CN.…”

“…60 A meta-analysis of patients with mRCC receiving TKI showed that high pretreatment NLR is associated with a poor prognosis. 68 Several studies showed the impact of NLR for the prediction of survival benefit in patients undergoing CN. Although OS was significantly better in the NTx group than in the non-NTx group, OS in a subgroup of patients with a high NLR was similar to that in the non-NTx group.…”