Prognostic role of the neutrophil–lymphocyte ratio in renal cell carcinoma: a meta-analysis

Hu, Kaimin; Lou, Lixia; Ye, Juan; Zhang, Suzhan

doi:10.1136/bmjopen-2014-006404

Cited by 127 publications

(123 citation statements)

References 39 publications

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“…The neutrophil-lymphocyte ratio (NLR) has been shown to be a well-validated prognostic factor in solid tumors such as those of the lung and breast, as well as hepatocellular and renal cell carcinomas [8][9][10][11][12]. The NLR is a well-known biomarker of cancer-associated inflammation.…”

Section: Introductionmentioning

confidence: 99%

Prognostic implication of antitumor immunity measured by the neutrophil–lymphocyte ratio and serum cytokines and angiogenic factors in gastric cancer

et al. 2016

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Background The neutrophil-lymphocyte ratio (NLR) is associated with a poor prognosis in many cancers but the biological mechanisms involved are unknown. Since cytokines and angiogenic factors (CAFs) are reflected by various immune responses, we analyzed the association between the NLR and CAFs and their prognostic implications in gastric cancer (GC). Methods Of 745 GC patients who were enrolled in NLR analysis, 70 underwent NLR and CAF association analyses. Pretreatment serum levels of 52 CAFs were measured by means of multiplex bead immunoassays and enzymelinked immunosorbent assays. Linear regression analysis and survival analysis of the NLR with each CAF were performed. Results Metastatic organ numbers and carbohydrate antigen 19-9 levels were significantly higher in patients with a high NLR [greater than 2.42 (median): P = 0.047 and P \ 0.001 respectively]. The overall survival was significantly worse in the high NLR group (17.8 months vs 11.2 months, P \ 0.001). In CAF analysis, osteopontin (R 2 = 0.337, P \ 0.001) and interleukin-6 (R 2 = 0.141, P = 0.001) were significantly associated with the NLR. Stromal-cell-derived factor 1 (SDF-1) was a significant poor prognostic factor independently of the NLR. Consideration of both the NLR and SDF-1 divided patient groups with different overall survival (both low, 21.0 months; either high, 15.8 months; both high, 8.2 months). Conclusion The NLR is a significant poor prognostic factor in advanced GC. The NLR is mainly associated with osteopontin and interleukin-6. Besides the NLR, SDF-1 is an independent poor prognostic factor in GC. Consideration of both the NLR and SDF-1 might give insights into antitumor immunity in GC.

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Section: Introductionmentioning

confidence: 99%

Prognostic implication of antitumor immunity measured by the neutrophil–lymphocyte ratio and serum cytokines and angiogenic factors in gastric cancer

et al. 2016

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“…A previous study was focused on the significant implication of inflammatory response in the progression of mRCC. 15 Patients with advanced RCC sometimes show paraneoplastic syndrome with fever and leukocytosis. The involvement of several molecules related to inflammation, such as interleukin-6 , 16 nuclear factor-kappa B, 17 and CRP, 10,11,13 on the progression of RCC have been previously demonstrated.…”

Section: Discussionmentioning

confidence: 99%

“…We chose three as a threshold value of pretreatment NLR based on the previous Impact of neutrophil-to-lymphocyte ratio on effects of targeted therapy for metastatic renal cell carcinoma patients with extrapulmonary metastasis report. 15 Cases for which the pretreatment NLR was three or higher and the others were classified into high and low NLR groups, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…13 Besides CRP, the elevation of the neutrophils-to-lymphocytes ratio (NLR) has been reported as a prognostic factor in cancers, including RCC. 14 Although various studies have shown the association between high NLR and poor prognosis of RCC, 14,15 there has been no report on determining the impact of the NLR on the effects of targeted agents regarding metastatic organ status. We therefore investigated the impact of pretreatment NLR on the effect of molecular targeted therapy for mRCC by focusing on the site of metastatic organs.…”

Section: Introductionmentioning

confidence: 99%

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Impact of neutrophil-to-lymphocyte ratio on effects of targeted therapy for metastatic renal cell carcinoma patients with extrapulmonary metastasis

Teishima

Ohara

Sadahide

et al. 2017

CUAJ

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Introduction: The aim of our present study was to investigate the impact of the pretreatment neutrophil-to-lymphocyte ratio (NLR) on the antitumour effects of targeted agents in patients with metastatic renal cell carcinoma (mRCC). Methods: The NLRs in 283 cases of molecular targeted therapy for mRCC were measured before starting the prescription of the molecular targeted agent. The significance of pretreatment NLR on the site of metastatic organs and on progression-free survival (PFS) in each case was analyzed. Results: Metastases other than lung, which is defined as "extrapulmonary metastasis," were observed in 190 cases (67.1%). The median of pretreated NLR was 2.39 (0.49-68.7). In 97 of the 283 cases, pretreated NLR was 3.0 or higher. These cases were categorized as the high NLR group and the rest as the low NLR group. When the cases with extrapulmonary metastasis were investigated and classified based on their pretreated NLR, 50% PFS in the high NLR and low NLR groups was 6.7 months and 12 months (p=0.0001), respectively. Multivariate analysis revealed that high NLR (>3.0) was an independent predictive factor for PFS in the cases with extrapulmonary metastasis (hazard ratio 2.762; p<0.0001), while there was no significant difference between PFS in the high and low NLR groups in cases with no extrapulmonary metastasis (p=0.3457). Conclusions: Our data indicate that the predictive significance of the NLR in mRCC cases involving targeted therapy depends on the metastatic organs. NLR is an independent predictive factor of PFS in cases of mRCC with extrapulmonary metastasis treated with targeted therapy.

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“…The neutrophil-to-lymphocyte ratio (NLR), a measure of systemic inflammation, has been reported as a predictive parameter of patient prognosis in various cancers, including RCC [3]. Although RCC is considered an immunogenic cancer, immunotherapy is not always effective.…”

Section: Introductionmentioning

confidence: 99%

The Neutrophil-to-Lymphocyte Ratio as A Prognostic Factor For Long-Term Interleukin-2 Use in Renal Cell Carcinoma

Nagai¹,

Okamura²,

Tanaka³

et al. 2017

Immunome Res

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The neutrophil-to-lymphocyte ratio (NLR), a measure of systemic inflammation, has been reported to be a predictive parameter of patient prognosis. We speculated that the NLR is decreased in renal cell carcinoma (RCC) patients in whom interleukin (IL)-2 is effective. In this study, we retrospectively examined the usefulness of the NLR as a prognostic factor using three cases of RCC treated with long-term IL-2. In all three cases, the NLR remained less than 2.7 during IL-2 treatment, suggesting its effectiveness as a marker. During interferon-α or molecular targeted drug therapy, the NLR was unstable, regardless of treatment effectiveness, but a sudden rise in the NLR tended to suggest massive radiographic progression and worse prognosis. The results suggested that the NLR might serve as a useful marker for therapies when determining prognosis.

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Prognostic role of the neutrophil–lymphocyte ratio in renal cell carcinoma: a meta-analysis

Cited by 127 publications

References 39 publications

Prognostic implication of antitumor immunity measured by the neutrophil–lymphocyte ratio and serum cytokines and angiogenic factors in gastric cancer

Prognostic implication of antitumor immunity measured by the neutrophil–lymphocyte ratio and serum cytokines and angiogenic factors in gastric cancer

Impact of neutrophil-to-lymphocyte ratio on effects of targeted therapy for metastatic renal cell carcinoma patients with extrapulmonary metastasis

The Neutrophil-to-Lymphocyte Ratio as A Prognostic Factor For Long-Term Interleukin-2 Use in Renal Cell Carcinoma

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