Preoperative Neutrophil to Lymphocyte Ratio as a Prognostic Factor in Patients with Non-metastatic Renal Cell Carcinoma

  • Wen, Ru-Min (Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute) ;
  • Zhang, Yi-Jing (Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute) ;
  • Ma, Sha (Department of Hematology, the Affiliated Hospital of Xuzhou Medical College) ;
  • Xu, Ying-Li (Department of Operation, the Affiliated Hospital of Xuzhou Medical College) ;
  • Chen, Yan-Su (Department of Public health, Xuzhou Medical College) ;
  • Li, Hai-Long (Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute) ;
  • Bai, Jin (Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute) ;
  • Zheng, Jun-Nian (Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute)
  • Published : 2015.05.18


Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with colorectal, lung, gastric cancer, pancreatic and metastatic renal cell carcinoma. We here evaluated whether preoperative NLR is an independent prognostic factor for non-metastatic renal cell carcinoma (RCC). Materials and Methods: Data from 327 patients who underwent curative or palliative nephrectomy were evaluated retrospectively. In preoperative blood routine examination, neutrophils and lymphocytes were obtained. The predictive value of NLR for non-metastatic RCC was analyzed. Results: The NLR of 327 patients was $2.72{\pm}2.25$. NLR <1.7 and NLR ${\geq}1.7$ were classified as low and high NLR groups, respectively. Chi-square test showed that the preoperative NLR was significantly correlated with the tumor size (P=0.025), but not with the histological subtype (P=0.095)and the pT stage (P=0.283). Overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method. Effects of NLR on OS (P=0.007) and DFS (P=0.011) were significant. To evaluate the independent prognostic significance of NLR, multivariate COX regression models were applied and identified increased NLR as an independent prognostic factor for OS (P=0.015), and DFS (P=0.019). Conclusions: Regarding patient survival, an increased NLR represented an independent risk factor, which might reflect a higher risk for severe cardiovascular and other comorbidities. An elevated blood NLR may be a biomarker of poor OS and DFS in patients with non-metastatic RCC.


Non-metastatic renal cell carcinoma;neutrophil-to-lymphocyte ratio;overall survival;disease-free survival


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