Neutrophil–lymphocyte ratio predicts survival in advanced renal cell carcinoma

The pretreatment value of elevated neutrophil–lymphocyte ratio appears to be predictive of poor overall survival in patients with advanced renal cell carcinoma, suggests a recent study.

The investigators described the prognostic value of neutrophil­–lymphocyte ratio and its effect on survival in this retrospective analysis of 331 patients. The cutoff value of neutrophil–lymphocyte ratio was specified as 3, which is clinically easy to apply and close to the median neutrophil–lymphocyte ratio level of the study group.

High group was characterized as having neutrophil–lymphocyte ratio >3 (n=160) and low group as having neutrophil–lymphocyte ≤3 (n=163).

Of the 311 patients with advanced renal cell carcinoma (median age, 58 years), 211 were male and 120 were female. Two hundred and forty-one patients (72.8 percent) had their International Metastatic RCC Database Consortium risk score calculated. Among them, 22 percent had a favourable, 45.2 percent had intermediate, and 32.8 percent had poor risk rates.

Seventy-eight percent of the patients were administered tyrosine kinase inhibitors. The median overall survival was substantially longer in the neutrophil–lymphocyte low group than the high group (32 vs 11 months; hazard ratio, 0.49, 95 percent confidence interval, 0.37–0.65; p<0.001).

These findings were consistent with those of an earlier study, which reported that neutrophil–lymphocyte ratio was a prognostic factor for disease-free survival after surgery with curative intent for localized nonclear cell renal cell carcinoma. The authors suggested that the neutrophil–lymphocyte ration could provide meaningful adjunct for patient counseling and clinical trial design. [J Urol 2013;190:1999-2004]