Objective:Several inflammatory markers have been studied as potential biomarkers in renal cell carcinoma(RCC),however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies.We ...Objective:Several inflammatory markers have been studied as potential biomarkers in renal cell carcinoma(RCC),however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies.We hypothesize that a combination of specific inflammatory markers into an RCC Inflammatory Score(RISK)could serve as a rigorous prognostic indicator of overall survival(OS)in patients with clear cell and non-clear cell RCC.Methods:Combination of preoperative C-reactive protein(CRP),albumin,erythrocyte sedimentation rate(ESR),corrected calcium,and aspartate transaminase to alanine transaminase(AST/ALT)ratio was used to develop RISK.RISK was developed using grid-search methodology,receiver-operating-characteristic(ROC)analysis,and sensitivity-specificity trade-off analysis.Prognostic value of RISK was analyzed using the KaplaneMeier method and Cox proportional regression models.Predictive accuracy was compared with RISK to Size,Size,Grade,and Necrosis(SSIGN)score,University of California-LOS Angeles(UCLA)Integrated Staging System(UISS),and Leibovich Prognosis Score(LPS).展开更多
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 disea...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.展开更多
文摘Objective:Several inflammatory markers have been studied as potential biomarkers in renal cell carcinoma(RCC),however few reports have analyzed their prognostic value in aggregate and in non-clear cell histologies.We hypothesize that a combination of specific inflammatory markers into an RCC Inflammatory Score(RISK)could serve as a rigorous prognostic indicator of overall survival(OS)in patients with clear cell and non-clear cell RCC.Methods:Combination of preoperative C-reactive protein(CRP),albumin,erythrocyte sedimentation rate(ESR),corrected calcium,and aspartate transaminase to alanine transaminase(AST/ALT)ratio was used to develop RISK.RISK was developed using grid-search methodology,receiver-operating-characteristic(ROC)analysis,and sensitivity-specificity trade-off analysis.Prognostic value of RISK was analyzed using the KaplaneMeier method and Cox proportional regression models.Predictive accuracy was compared with RISK to Size,Size,Grade,and Necrosis(SSIGN)score,University of California-LOS Angeles(UCLA)Integrated Staging System(UISS),and Leibovich Prognosis Score(LPS).
文摘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.
