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Preoperative Neutrophil-lymphocyte Ratio as a Predictor of Overall Survival in Patients with Localized Renal Cell Carcinoma

Damian Widz, Przemyslaw Mitura, Pawel Buraczynski, Pawel Plaza, Marek Bar, Michal Cabanek, Grzegorz Nowak, Anna Ostrowska, Krzysztof Bar



Purpose: The neutrophil-to-lymphocyte ratio (NLR), as an indicator of the systemic inflammatory response, predicts adverse outcomes in many malignancies. We investigated its prognostic significance in patients with non-metastatic renal cell carcinoma.

Materials and Methods: We retrospectively evaluated data of 196 consecutive non-metastatic RCC patients who underwent radical or partial nephrectomy between 2010 and 2012 at a single center. Overall survival (OS) was assessed using the Kaplan-Meier method and compared using the log-rank test. We applied univariate and multivariate Cox regression models to evaluate the prognostic value of dichotomized NLR for OS.   

Results: At a median follow up of 68 months, high NLR (? 2,69) correlated with worse survival outcome (P = .006 in log-rank test) and higher tumor stage (P = .035). Univariate and multivariate analysis identified elevated NLR (P = .039), as well as age (P = .002), high Fuhrmann grade (P = .002) and high pathologic T stage (P < .001), as significantly associated with overall survival.

Conclusion: In our cohort, an elevated neutrophil-to-lymphocyte ratio is significantly associated with worse OS on univariate and multivariate analysis. Consequently, the NLR is an easily acquired biomarker, which may be useful in pretreatment patient risk stratification.


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DOI: http://dx.doi.org/10.22037/uj.v0i0.4541


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