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

Abstract

Objective(s): The aim of this analysis was to evaluate the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), platelets (PLT), and neutrophil level for their prognostic value in patients with metastatic renal cell carcinoma (mRCC). Materials: We retrospectively reviewed medical records of 141 patients with mRCC (2006–2016). Univariate and multivariate analyses were performed with the Cox proportional hazards regression model. The cutoff value of NLR was “elevated” as >3.68 and the PLR cutoff value was “elevated” as >144.4. Results: The median PFS and OS were shorter in elevated NLR and PLR. A higher value of PLT was associated with worse median OS and higher neutrophil level with worse OS and PFS. In multivariate analysis, higher NLR (p = 0.007) and PLR (p = 0.006) were independent prognostic factors for shorter OS together with BMI ≤30 (p = 0.004), higher Fuhrman grade (p = 0.0002), lower level of hemoglobin (p= 0.010), and ZUBROD 2 (p = 0.0002). Higher PLR (p = 0.0002) was an independent negative prognostic factor for PFS together with higher Fuhrman grade (p = 0.001), higher neutrophil level (p = 0.001), and lower lymphocyte level (p = 0.013). Conclusion: Elevated pretreatment NLR, PLR, PLT, and neutrophil count are associated with shorter OS and PFS in patients with mRCC. NLR and PLR are independent prognostic factors for OS. However, PLR and neutrophil count are independent prognostic factors for PFS.

Preoperative Anemia and Thrombocytosis Predict Adverse Prognosis in Non-Metastatic Renal Cell Carcinoma With Tumor Thrombus

“…Although some researcher found NLR, PLR and AST/ALT and Alb level could be used as prognostic factors in RCC [8][9][10][11][12], in population of RCC with TT we could not found any statistically signi cant difference. Firstly, we supposed in patients of RCC with TT, the in ammatory status could be more complex, thus these kinds of blood marker may not suitable for speci c kind of populations.…”

“…Preoperative In ammation indicators such as neutrophils, lymphocytes, platelets, neutrophil-lymphocyte ratio (NLR) and the platelet lymphocyte ratio (PLR) have been demonstrated to be prognostic value in some urologic malignancies like prostate cancer and bladder cancer [6,7]. In RCC, elevated neutrophils, platelets, NLR, PLR and decreased lymphocytes was associated with worse survival in previous study [8][9][10][11]. Besides, other preoperative blood parameters like hemoglobin, AST/ALT, albumin have been reported as prognostic factors in predicting RCC survival [12].…”

Comparison of non‐invasive liver reserve and fibrosis models: Implications for surgery and prognosis for hepatocellular carcinoma

“…In addition, those platelet‐derived factors can potentially enhance tumor ability to metastasis and have been reported as a protector of tumor cells from host immune response to support the progression . Furthermore, accumulating evidence suggests the significant association of platelet or platelet‐associated models, such as platelet–lymphocyte ratio and cancer prognosis . Thus, serum platelet count might reflect tumor nature and further analyses are needed for revealing true mechanisms of association between PALBI and tumor features.…”

“…27 Furthermore, accumulating evidence suggests the significant association of platelet or plateletassociated models, such as platelet-lymphocyte ratio and cancer prognosis. 28 Thus, serum platelet count might reflect tumor nature and further analyses are needed for revealing true mechanisms of association between PALBI and tumor features. Consequently, PALBI, FIB-4, and APRI can robustly predict postoperative prognosis after hepatectomy, and PALBI might provide useful information for perioperative risks associated with hepatectomy before surgery.…”

Preoperative systemic immune-inflammation index predicts prognosis of patients with non-metastatic renal cell carcinoma: a propensity score-matched analysis

“…Besides, complement could be leveraged by neoplasms to promote tumorigenic microenvironments and antibody-dependent complement activity is associated with antitumor e cacy 11 . Previous reported has shown that circulating immune-in ammatory cells, such as lymphocytes, neutrophils, and platelet, could contribute to promoting cancer cell proliferation and invasion [8][9][12][13] . Several studies have evaluated these circulating cells and found that they are associated with the prognosis of malignancies [13][14] .…”