Abstract
Inflammation-based prognostic scores are useful for predicting survival in various cancers. Here, we aimed to determine the most useful inflammation-based prognostic score for predicting survival in patients with metastatic renal cell carcinoma undergoing cytoreductive nephrectomy. We retrospectively analyzed the data of 152 patients who underwent cytoreductive nephrectomy for metastatic renal cell carcinoma between 1986 and 2015. In the multivariate stepwise analysis, the combination of age, Memorial Sloan-Kettering Cancer Center score, histology, sarcomatoid change, clinical nodal stage, brain metastasis, and liver metastasis was a significant predictor for survival (Harrell's concordance index [c-index]: 0.638). The c-index of the combination improved with the addition of an inflammation-based prognostic score: C-reactive protein (c-index: 0.672), Glasgow prognostic score (c-index: 0.674), neutrophil-to-lymphocyte ratio (c-index: 0.685), lymphocyte-to-monocyte ratio (c-index: 0.670), platelet-to-lymphocyte ratio (c-index: 0.666), systemic inflammation response index (c-index: 0.652), and systemic immune-inflammation index (c-index: 0.678). The neutrophil-to-lymphocyte ratio provided the greatest improvement in the c-index. Additional multivariate analysis showed that the neutrophil-to-lymphocyte ratio was an independent prognostic factor for survival (P < 0.0001). The neutrophil-to-lymphocyte ratio was the most useful inflammation-based prognostic score for predicting survival in patients with metastatic renal cell carcinoma treated with cytoreductive nephrectomy.
Highlights
Cancers of the kidney and renal pelvis account for approximately 3% of all adult tumors
The neutrophil-to-lymphocyte ratio was the most useful inflammationbased prognostic score for predicting survival in patients with metastatic renal cell carcinoma treated with cytoreductive nephrectomy
The present study investigated various predictors, including inflammation-based prognostic scores, of survival in patients with metastatic renal cell carcinoma (mRCC) who underwent cytoreductive nephrectomy (CN)
Summary
Cancers of the kidney and renal pelvis account for approximately 3% of all adult tumors. Several agents targeting the vascular endothelial growth factor (VEGF) [6,7,8,9] and mammalian target of rapamycin pathways [10, 11], were introduced to mRCC www.impactjournals.com/oncotarget treatment, some retrospective studies suggesting similar survival benefit of CN have existed [12,13,14,15], conflict opinions have been reported [16] These controversial results are currently being evaluated by two ongoing randomized trials (CARMENE and SURTIME). Because not all patients with mRCC will benefit from CN, prognostic factors affecting mRCC patients should be investigated to optimize the benefits of CN
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
