Nader Marta Guilherme, Isaacsson Velho Pedro, Bonadio Renata R C, Nardo Mirella, Faraj Sheila F, de Azevedo Souza Manoel Carlos L, Muniz David Q B, Bastos Diogo Assed, Dzik Carlos
Instituto do Cancer do Estado de Sao Paulo, Av. Dr. Arnaldo, 251, Sao Paulo, SP, 01246-000, Brazil.
Johns Hopkins Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, MD, USA.
Pathol Oncol Res. 2020 Oct;26(4):2489-2497. doi: 10.1007/s12253-020-00840-0. Epub 2020 Jun 24.
Metastatic renal cell carcinoma (mRCC) encompasses a heterogeneous group of neoplasms with distinct clinical behavior and prognoses. As a result of the increasing number of therapeutic options in the metastatic setting, it is crucial to improve prognostic stratification ability. We aimed to evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and combination platelet count and neutrophil lymphocyte ratio (COP-NLR) in patients with mRCC. We evaluated a cohort of mRCC patients treated with first-line pazopanib or sunitinib. Levels of NLR, PLR and COP-NLR were measured prior to systemic treatment and evaluated as prognostic predictors. Primary endpoint was overall survival (OS). Data from 276 patients were included, of which 54.7% received first-line pazopanib and 45.3%, sunitinib. Memorial Sloan-Kettering Cancer Center risk classification was intermediate and poor in 50% and 42.6% of patients, respectively. High NLR (> 3.5) was associated with inferior OS (median 9.6 vs 17.8 months, P < 0.001). A high PLR (> 200) was associated with inferior OS (median 10.3 vs 17 months, P = 0.002). The median OS in the COP-NLR 1, 2 and 3 groups were 19.0 months (95% CI 15.3-26.0), 13.1 months (95% CI 9.8-17.0) and 7.4 months (95% CI 3.6-11.9), respectively (P < 0.001). In the multivariate analysis, high NLR and high COP-NLR were associated with inferior OS. Both high NLR and high COP-NLR were associated with poorer OS in our cohort of patients with mRCC treated with first-line pazopanib or sunitinib.
转移性肾细胞癌（mRCC）是一组具有不同临床行为和预后的异质性肿瘤。由于转移性环境中治疗选择的增加，提高预后分层能力至关重要。我们旨在评估中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）以及血小板计数与中性粒细胞淋巴细胞比值组合（COP-NLR）在mRCC患者中的预后价值。我们评估了一组接受一线帕唑帕尼或舒尼替尼治疗的mRCC患者。在全身治疗前测量NLR、PLR和COP-NLR水平，并将其作为预后预测指标进行评估。主要终点是总生存期（OS）。纳入了276例患者的数据，其中54.7%接受一线帕唑帕尼治疗，45.3%接受舒尼替尼治疗。纪念斯隆凯特琳癌症中心风险分类在50%和42.6%的患者中分别为中度和差。高NLR（>3.5）与较差的OS相关（中位生存期9.6个月对17.8个月，P<0.001）。高PLR（>200）与较差的OS相关（中位生存期10.3个月对17个月，P = 0.002）。COP-NLR 1、2和3组的中位OS分别为19.0个月（95%CI 15.3 - 26.0）、13.1个月（95%CI 9.8 - 17.0）和7.4个月（95%CI 3.6 - 11.9）（P<0.001）。在多变量分析中，高NLR和高COP-NLR与较差的OS相关。在我们接受一线帕唑帕尼或舒尼替尼治疗的mRCC患者队列中，高NLR和高COP-NLR均与较差的OS相关。
