The De Ritis and Neutrophil-to-Lymphocyte Ratios May Aid in the Risk Assessment of Patients with Metastatic Renal Cell Carcinoma

Abstract

Purpose This study aimed to determine whether baseline blood inflammatory markers can predict progression-free survival (PFS) and overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC). Methods The study included 158 patients with mRCC treated with first-line targeted therapy between 2002 and 2016. A multivariable cox proportional hazards model identified inflammatory factors that predict PFS and OS. Using bootstrap method, new prognostic model compared with Heng and modified MSKCC risk model (mMSKCC). The effect of inflammatory factors were investigated by comparing increased C-index adding significant inflammatory factors to Heng and mMSKCC model. Results On multivariable analysis, nephrectomy (HR 0.48), NLR (HR 1.04), were significant risk factors for PFS; nephrectomy (HR 0.38), hemoglobin (HR 1.71), alkaline phosphatase (HR 1.73), NLR (HR 1.01) and DRR (HR 1.34), were significant factors for OS (p<0.05). Our new model that incorporated NLR and DRR had higher (though insignificant) predictability (C-index=0.610) than mMSKCC risk model (C-index=0.569) in PFS and significantly better predictability (C-index=0.727) than Heng and mMSKCC risk model (C-index, 0.661, 0.612, respectively) in OS. Adding inflammatory factors to the Heng criteria (C-index, 0.697 for OS) and MSKCC (0.691 for OS) tended to improve their predictive abilities. Conclusions The NLR and DRR may increase predictive ability compared to the established Heng and mMSKCC risk models in mRCC.

Support Vector Machine-Based Classifier for the Assessment of Finger Movement of Stroke Patients Undergoing Rehabilitation

“…Thereafter, 1000 bootstrap data values were generated by randomly drawing a series of sample data from the actual kinematics-related data. This bootstrap resampling method is widely used in demographic studies [17][18][19]. Then, the bootstrap kinematics-related data were inputted into a nonlinear SVM [20].…”

Pre-treatment De Ritis ratio serves as a potential prognostic biomarker in renal cell carcinoma: a systematic review and meta-analysis

“…Initially identi ed 267 articles through the search strategy, 19 studies remained after removing duplicates and excluding articles by viewing titles and abstracts. Based on corresponding inclusion and exclusion criteria, 8 articles comprising 5,025 patients were nally included in the present study [14,15,[18][19][20][21][22][23] ( Figure 1). All studies had a retrospective design, two of which were propensity score-matched analyses.…”

“…3 studies focused on metastatic RCC [19,21,22], 5 studies focused on non-metastatic RCC [14,15,18,20,23]. These studies were conducted in ve countries, including China, Korea, Turkey, Japan, and the United States.…”

“…Cut-off values for the De Ritis ratio ranged from 1.0 to 1.5. The median follow-up period for the included studies ranged from 21 to 60 months, and only one study not reported the follow-up period [22]. 7 studies recorded the connections of De Ritis ratio with OS, 5 studies recorded CSS, 2 studies recorded PFS, and only study recorded MFS [14].…”

“…Seven studies including 4,782 patients recorded about OS [14,15,[18][19][20][21][22]. Since moderate heterogeneity was found, the random-effects model was adopted (I 2 = 47.5%, P = 0.076).…”