Abstract
Objective To explore prognostic factors of renal cell carcinoma and investigate the association of neutrophil-to-lymphocyte ratio (NLR) with the prognosis of renal cell carcinoma (RCC) in patients who received nephrectomy treatment. Methods We retrospectively reviewed the records of 1325 patients with renal cell carcinoma who underwent nephrectomy between January, 2008 and December, 2012. We retrospectively analyzed the clinicopathologic characteristics of patients. The optimal cutoff value for NLR was determined using receiver operating characteristic curve (ROC) analysis. We defined them as high NLR group when NLR ≥ 2.7 and low NLR group when NLR<2.7. Overall survival (OS) and recurrence free survival (RFS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate models were used to analyze the association of NLR with clinicopathologic outcomes. Results By the end of the study, 1220 cases were followed up. The follow-up rate was 92.1%. Mean follow-up was 40 months (range 2 months to 87 months). The three-year and five-year overall survival rate were 91.3% and 86.9%, respectively. Meanwhile the three-year and five-year recurrence free survival rate were 88.2% and 85.8%, respectively. 2.7 was selected as the optimal cutoff value to differentiate between low NLR and high NLR. A NLR ≥2.7 was significantly associated with worse 5-year overall survival and worse 5-year recurrence free survival than a NLR 65, presentation mode with symptom, higher tumor stage, higher Fuhrman grade, histologic subtype, neutrophil count≥4.5, lymphocyte count<1.7, NLR ≥2.7 significantly correlated with poor OS on univariate analysis. Multivariate analysis revealed that higher tumor stage, preoperative NLR ≥2.7 at diagnosis were poor independent prognostic factors for OS of renal cell carcinoma. Conclusion High NLR was independent poor predictor of renal cell carcinoma. Key words: Carcinoma, renal cell; Neutrophil-to-lymphocyte ratio; Prognosis; Survival rate
Published Version
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