摘要
Objective:Inflammatory serum markers have proven to be a powerful predictive tool of patient prognosis in cancer treatment for a wide variety of solid organ malignancies,predominantly in the context of localized disease.In this study we evaluated the preoperative neutrophil-to-lymphocyte ratio(NLR)as a predictive tool in patients with metastatic clear cell renal cell carcinoma(RCC).Methods:Sixty-four patients with metastatic clear cell RCC undergoing nephrectomy were selected.Only patients with preoperative NLR were included for survival analysis.Patients were categorized into high and low NLR score determined by plotting the NLR ROC curve.Multivariable analysis was performed.Results:Median age was 60.8 years(38.2-81.2).Median follow-up time was 8.1 months(0.1-106.3).Fuhrman grade distribution was:2(3.1%)grade 1,6(9.4%)grade 2,24(37.5%)grade 3 and 32(50.0%)grade 4.Median NLR score was 3.5(1.4-31.0).NLR4 was associated with decreased overall survival compared toNLR<4(p=0.017).Multivariable survival analysis showed NLR4 as an independent predictor of survival(Hazard ratio(HR)2.41,95%CI 1.05-5.50,p=0.03).Conclusion:Elevated preoperative NLR is associatedwith poor prognosis in patients withmetastatic kidney cancer.Preoperative NLR is a useful tool,which can predict prognosis,stratify patients for postoperative surveillance,and help guide decisions for therapy.
