Preoperative Neutrophil to Lymphocyte Ratio as a Prognostic Factor in Patients with Non-metastatic Renal Cell Carcinoma

Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients withcolorectal, lung, gastric cancer, pancreatic and metastatic renal cell carcinoma. We here evaluated whetherpreoperative NLR is an independent prognostic factor for non-metastatic renal cell carcinoma (RCC). Materialsand
Methods: Data from 327 patients who underwent curative or palliative nephrectomy were evaluatedretrospectively. In preoperative blood routine examination, neutrophils and lymphocytes were obtained. Thepredictive value of NLR for non-metastatic RCC was analyzed.
Results: The NLR of 327 patients was 2.72±2.25.NLR <1.7 and NLR ≥1.7 were classified as low and high NLR groups, respectively. Chi-square test showed thatthe preoperative NLR was significantly correlated with the tumor size (P=0.025), but not with the histologicalsubtype (P=0.095)and the pT stage (P=0.283). Overall survival (OS) and disease-free survival (DFS) wereassessed using the Kaplan-Meier method. Effects of NLR on OS (P=0.007) and DFS (P=0.011) were significant. Toevaluate the independent prognostic significance of NLR, multivariate COX regression models were applied andidentified increased NLR as an independent prognostic factor for OS (P=0.015), and DFS (P=0.019).
Conclusions:Regarding patient survival, an increased NLR represented an independent risk factor, which might reflect ahigher risk for severe cardiovascular and other comorbidities. An elevated blood NLR may be a biomarker ofpoor OS and DFS in patients with non-metastatic RCC.