Prognostic significance of platelet–lymphocyte ratio in patients receiving first-line tyrosine kinase inhibitors for metastatic renal cell cancer

Abstract

BackgroundThe platelet–lymphocyte ratio (PLR) and neutrophil–lymphocyte ratio (NLR) have been reported as prognostic factors in various cancers, but their roles in metastatic renal cell cancer (mRCC) remain unclear. We investigated the significance of PLR and NLR, along with that of established prognostic factors, in mRCC patients receiving first-line tyrosine kinase inhibitors (TKI).MethodsData obtained from 63 mRCC patients who received first-line TKI between 2007 and 2013 were evaluated retrospectively. The association of PLR, NLR, and established prognostic factors with progression-free survival (PFS) and overall survival (OS) was analyzed using the Kaplan–Meier method. The influence of independent prognostic factors on survival was determined using multivariable Cox regression analysis.ResultsHigh NLR (>3.6) and PLR (>150) were related to shorter PFS (p = 0.001) and OS (p = 0.001). The presence of brain metastases [hazard ratio (HR) 4.94, 95% CI 1.75–13.9; p = 0.002] and high PLR (>150, HR 13.1, 95% CI 5.14–33.2; p = 0.001) were independently associated with PFS, and Eastern Cooperative Oncology Group Performance status ≥2 (HR 3.60, 95% CI 1.39–9.31; p = 0.008), lymph node metastasis (HR 2.76, 95% CI 1.11–6.86; p = 0.029), brain metastasis (HR 9.39, 95% CI 2.74–32.1; p = 0.001), and high PLR (>150, HR 16.1, 95% CI 4.41–58.4; p = 0.001) with OS.ConclusionsHigh PLR was associated with shorter survival of mRCC patients receiving first-line TKI. The PLR may be an effective independent prognostic factor in this setting.

After neoadjuvant chemotherapy platelet/lymphocyte ratios negatively correlate with prognosis in gastric cancer patients

“…In the last decade, more and more studies have reported that the systemic inflammatory response is closely related to a poor outcome in many types of tumor . The accumulating increase in NLR and PLR may be caused by peritumoral inflammation produced by a huge amount of cancer cells in patients with advanced cancer.…”

The Role of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio, and Platelets in the Prognosis of Metastatic Renal Cell Carcinoma

“…In a study conducted by Park et al [25], the presence of brain metastases (HR 4.94, 95% CI 1.75–13.9, p = 0.002) and high PLR (>150, HR 13.1, 95% CI 5.14–33.2, p = 0.001) were independently associated with PFS. However, Eastern Cooperative Oncology Group Performance status ≥2 (HR 3.60, 95% CI 1.39–9.31, p = 0.008), lymph node metastasis (HR 2.76, 95% CI 1.11–6.86, p = 0.029), brain metastasis (HR 9.39, 95% CI 2.74–32.1, p = 0.001), and high PLR (>150, HR 16.1, 95% CI 4.41–58.4, p = 0.001) were associated with OS [25].…”

“…However, Eastern Cooperative Oncology Group Performance status ≥2 (HR 3.60, 95% CI 1.39–9.31, p = 0.008), lymph node metastasis (HR 2.76, 95% CI 1.11–6.86, p = 0.029), brain metastasis (HR 9.39, 95% CI 2.74–32.1, p = 0.001), and high PLR (>150, HR 16.1, 95% CI 4.41–58.4, p = 0.001) were associated with OS [25]. In our study, some tendency was reported to the presence of adipose tissue infiltration in patients  with higher PLR (>144.4) (41.5 vs. 27.1%, p = 0.108).…”

Role of systemic inflammatory response markers in urological malignancy

“…The PLR, as well as the NLR, is an inexpensive and easily acquired marker that can be used after a routine preoperative blood examination. Table summarizes the results of recent reports evaluating the prognostic value of PLR . The cut‐off value for high versus low PLR varied from 117.46 to 218.…”

“…Table 13 summarizes the results of recent reports evaluating the prognostic value of PLR. 35,43,108,115,[142][143][144][145][146][147][148][149][150][151] The cutoff value for high versus low PLR varied from 117.46 to 218. Higher PLR was significantly associated with poor prognosis in five of 14 studies.…”