Prognostic significance of lymphocyte-to-monocyte ratio and CRP in patients with nonmetastatic clear cell renal cell carcinoma: a retrospective multicenter analysis

Abstract

BackgroundInflammation has been reported to be involved in carcinogenesis and cancer progression. This study was designed to explore the prognostic significance of lymphocyte-to-monocyte ratio (LMR) and serum C-reactive protein (CRP) in nonmetastatic clear cell renal cell carcinoma (ccRCC) patients after treatment.MethodsThe retrospective study consisted of 985 patients with ccRCC who had undergone nephrectomy from 2005 to 2010 at multiple centers. The patients were divided into four groups using a quartile of LMR or CRP, and their associations with clinical characteristics and outcome were systematically estimated.ResultsBoth low LMR and high CRP significantly diminished overall survival (OS) and metastasis-free survival (MFS) in patients with ccRCC. Further investigation indicated that LMR and CRP were independent prognostic factors of both OS and MFS. Integration of LMR and CRP into a predictive model, including significant variables in multivariate analysis, established a nomogram to predict accurately the 3- and 5-year survival for nonmetastatic patients with ccRCC.ConclusionLMR and CRP represent independent prognostic factors of OS and MFS for patients with ccRCC. Incorporation of LMR and CRP into the traditional TNM staging system may improve their predictive performance.

The clinical use of the platelet to lymphocyte ratio and lymphocyte to monocyte ratio as prognostic factors in renal cell carcinoma: a systematic review and meta-analysis

“…The relationship between LMR and oncologic outcomes was described in 8 literatures containing 4,572 patients [ 10 , 13 , 16 – 18 , 20 , 21 , 23 ]. Of these studies, 6 reported the results of OS, 2 reported the results of PFS, 4 reported the results of RFS.…”

Fibrinogen and C-reactive protein score is a prognostic index for patients with hepatocellular carcinoma undergoing curative resection: a prognostic nomogram study

“…Furthermore, the prominent role of fibrinogen in predicting prognosis has been reported in a large number of cancers, including HCC, advanced esophageal squamous cell carcinoma, renal cell carcinoma, and esophageal squamous cell carcinoma 23 , 24 , 34 - 37 . CRP, which is another prominent system inflammation response factor, has been reported to be closely associated with prognosis in HCC, pancreatic cancer, renal cancer, gastric cancer, lung cancer and lymphoma 26 - 27 , 38 - 41 . Also, there were a systematic review and meta-analysis shown that high level of CRP and CRP/albumin were associated with poor survival 25 , 28 .…”

Glasgow prognostic score is a better predictor of the long-term survival in patients with gastric cancer, compared to the modified Glasgow prognostic score or high-sensitivity modified Glasgow prognostic score

“…Moreover, increasing evidence suggests that inflammation plays a role in cancer development and may also be accelerated by the cancer itself due to increased catabolism and malnutrition [18,19]. CRP, a reliable marker of systemic inflammation, reflects cell-mediated immunity associated with poor outcomes in several cancers [3,4]. Additionally, serum albumin levels are a leading indicator of nutritional status and serum albumin levels likely decrease secondarily to a systemic inflammatory response [1,2].…”

“…C-reactive protein (CRP) is a sensitive marker of an infectious or inflammatory disease state and is also an important hallmark of carcinogenesis and cancer progression [3,4]. The Glasgow prognostic score (GPS) is evaluated using serum CRP and albumin levels.…”