The predictive role of preoperative and postoperative neutrophil-lymphocyte ratio in sarcomatoid renal cell carcinoma Journal Article

Authors: Mano, R.; Flynn, J.; Blum, K. A.; Silagy, A. W.; DiNatale, R. G.; Marcon, J.; Wang, A.; Sanchez, A.; Coleman, J. A.; Russo, P.; Ostrovnaya, I.; Hakimi, A. A.
Article Title: The predictive role of preoperative and postoperative neutrophil-lymphocyte ratio in sarcomatoid renal cell carcinoma
Abstract: Objective: Preoperative inflammatory parameters are associated with outcome in renal cell carcinoma; however, their predictive value in tumors with sarcomatoid dedifferentiation (sRCC) is uncertain. We aimed to evaluate the association between preoperative and postoperative inflammatory parameters and the outcome of patients with locoregional and metastatic sRCC who underwent nephrectomy. Methods and materials: After obtaining IRB approval, we identified 230 patients with sRCC treated between 1994 and 2018 with a complete blood count drawn ≤1 month before nephrectomy. Preoperative neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio, and platelet-lymphocyte ratio were evaluated as continuous variables. Postoperative NLR, 1 to 8 weeks after surgery, and percentage change in NLR were calculated. Cox regression models were used to identify predictors of outcome. Results: The study cohort included 105 metastatic patients and 112 patients with locoregional disease. Patients with metastatic disease had significantly higher preoperative NLR (4.31 vs. 3.29) and PLR (248 vs. 194), and lower preoperative LMR (2.6 vs. 3.23). Median follow-up for patients with locoregional and metastatic disease was 36 months and 20 months, respectively, and estimated 5-year cancer-specific survival (CSS) rates were 56% and 15%, respectively. Preoperative NLR was a significant predictor of CSS for both metastatic (HR = 1.23, 95% CI 1.1–1.37, P < 0.001) and locoregional (HR = 1.09, 95% CI 1–1.2, P = 0.049) patients. For metastatic patients, postoperative NLR was significantly associated with CSS on univariate analysis; however, change in NLR was not associated with outcome. Conclusions: Preoperative NLR is associated with CSS in locoregional and metastatic sRCC. NLR should be considered when establishing future predictive models for sRCC. © 2019 Elsevier Inc.
Keywords: kidney; neutrophils; lymphocytes; prognosis; sarcomatoid renal cell carcinoma
Journal Title: Urologic Oncology: Seminars and Original Investigations
Volume: 37
Issue: 12
ISSN: 1078-1439
Publisher: Elsevier Inc.  
Date Published: 2019-12-01
Start Page: 916
End Page: 923
Language: English
DOI: 10.1016/j.urolonc.2019.09.006
PUBMED: 31590969
PROVIDER: scopus
Notes: Article -- Source: Scopus
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MSK Authors
  1. Jonathan Coleman
    206 Coleman
  2. Paul Russo
    476 Russo
  3. Abraham Ari Hakimi
    170 Hakimi
  4. Roy Mano
    28 Mano
  5. Jessica Flynn
    25 Flynn
  6. Alejandro Sanchez
    12 Sanchez
  7. Kyle Blum
    16 Blum
  8. Andrew William Silagy
    6 Silagy
  9. Julian Marcon
    6 Marcon
  10. Alan Wang
    1 Wang