Back to Search
Start Over
Prognostic value of neutrophil-to-lymphocyte ratio in patients with metastatic renal cell carcinoma treated with first-line and subsequent second-line targeted therapy: A proposal of the modified-IMDC risk model.
- Source :
-
Urologic oncology [Urol Oncol] 2017 Feb; Vol. 35 (2), pp. 39.e19-39.e28. Date of Electronic Publication: 2016 Nov 04. - Publication Year :
- 2017
-
Abstract
- Purpose: The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk model has been designed for prognostification in patients with metastatic renal cell carcinoma (mRCC) treated with targeted therapy. One factor is neutrophil count; however, increasing evidence has suggested the superiority of neutrophil-to-lymphocyte ratio (NLR) for predicting outcome. In this study, we evaluate the prognostic effect of NLR levels on patients with mRCC treated with targeted therapy, and then we compare the predictive accuracy of the IMDC risk model and its modified one by using NLR, instead of neutrophil count.<br />Patients and Method: A total of 277 patients are included for the analysis. All patients underwent targeted therapies and associated outcome are assessed using multivariate analysis.<br />Results: Pretreatment NLR levels are elevated in 30.3% and 23.1% of patients in the first-line and subsequent second-line setting, respectively. Kaplan-Meier curves reveal that elevated pretreatment NLR is significantly associated with poor overall survival (OS) since first-line (P<0.001) and second-line targeted therapy administration (P<0.001). Also, multivariate analyses show that elevated pretreatment NLR is an independent predictor for poor OS since first-line and second-line targeted therapy administration. The addition of NLR to the IMDC risk model, instead of neutrophil count, significantly improves the predictive accuracy for OS, and estimated gain is 1.7% and 6.2% in first-line and second-line targeted therapy, respectively.<br />Conclusion: Changes in NLR levels could be predictive for prognosis in patients with mRCC treated with first-line and second-line targeted therapy. The addition of NLR significantly improves the predictive accuracy of the IMDC risk model in the first-line and subsequent second-line setting.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Renal Cell pathology
Female
Humans
Kaplan-Meier Estimate
Kidney Neoplasms pathology
Leukocyte Count
Male
Middle Aged
Molecular Targeted Therapy
Multivariate Analysis
Neoplasm Metastasis
Outcome Assessment, Health Care methods
Outcome Assessment, Health Care statistics & numerical data
Prognosis
Proportional Hazards Models
Retrospective Studies
Carcinoma, Renal Cell drug therapy
Kidney Neoplasms drug therapy
Lymphocytes pathology
Neutrophils pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2496
- Volume :
- 35
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Urologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 27825515
- Full Text :
- https://doi.org/10.1016/j.urolonc.2016.10.001