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. 2017 Jan 3;116(1):85-90.
doi: 10.1038/bjc.2016.393. Epub 2016 Dec 1.

Critical evaluation of the potential prognostic value of the pretreatment-derived neutrophil-lymphocyte ratio under consideration of C-reactive protein levels in clear cell renal cell carcinoma

Orietta Dalpiaz  1 , Theresa Luef  1 , Maximilian Seles  1 , Michael Stotz  2 , Tatjana Stojakovic  3 , Karl Pummer  1 , Richard Zigeuner  1 , Georg C Hutterer  1 , Martin Pichler  2   4
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Critical evaluation of the potential prognostic value of the pretreatment-derived neutrophil-lymphocyte ratio under consideration of C-reactive protein levels in clear cell renal cell carcinoma

Orietta Dalpiaz et al. Br J Cancer. .

Abstract

Background: We investigated the prognostic value of the pretreatment-derived neutrophil-lymphocyte ratio (dNLR) and original NLR in relation to the commonly used inflammation marker C-reactive protein (CRP) in a large cohort of patients with clear cell renal cell carcinoma (RCC).

Methods: Clinicopathological data from 587 consecutive non-metastatic clear cell RCC patients, operated between 2000 and 2010 at a single tertiary academic center, were evaluated retrospectively. Patients were categorised according to a cutoff value derived from receiver operating curve analysis. Overall (OS), cancer-specific (CSS) as well as metastasis-free survival (MFS) were assessed using the Kaplan-Meier method and multivariate Cox proportional models were applied. Spearman's rank correlation coefficient tested the association between dNLR and other markers of the systemic inflammatory response.

Results: The significant correlation between pretreatment NLR and dNLR was strong (ρ=0.84), whereas between dNLR and CRP it was weak (ρ=0.18). In multivariate analyses, dNLR achieved independent predictor status regarding CSS (P=0.037) and MFS (P=0.041), whereas CRP was confirmed as independent predictor of OS (P=0.010), CSS (P=0.039) and MFS (P=0.005), respectively. The NLR failed to reach independent predictor status regarding OS, CSS and MFS when CRP was included into the multivariate model.

Conclusions: In the cohort studied, an elevated (⩾10.0) pretreatment CRP level and elevated dNLR (>2) were robust independent predictors of CSS and MFS. Our data suggest that CRP might be superior to both NLR and dNLR.

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Figures

Figure 1
Figure 1
Kaplan–Meier curves predicting OS, groups categorised by the pretreatment dNLR. A full colour version of this figure is available at the British Journal of Cancer online.
Figure 2
Figure 2
Kaplan–Meier curves predicting CSS, groups categorised by the pretreatment dNLR. A full colour version of this figure is available at the British Journal of Cancer online.
Figure 3
Figure 3
Kaplan–Meier curves predicting MFS, groups categorised by the pretreatment dNLR. A full colour version of this figure is available at the British Journal of Cancer online.
See this image and copyright information in PMC

References

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