Korean J Urol Oncol.  2019 Dec;17(3):150-159. 10.22465/kjuo.2019.17.3.150.

Prognostic Significance of Systemic Inflammatory Response in Patients with Synchronous and Metachronous Metastatic Renal Cell Carcinoma Receiving First-Line Tyrosine Kinase Inhibitors

• Choi J
• Kim TJ
• Sung HH
• Jeon HG
• Jeong BC
• Jeon SS
• Lee HM
• Choi HY
• Kang M
• Seo SI

• KMID: 2470400
• DOI: http://doi.org/10.22465/kjuo.2019.17.3.150

Abstract

PURPOSE
To determine whether systemic inflammatory response (SIR), particularly platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), has different prognostic role between patients with metastatic renal cell carcinoma (mRCC) receiving first-line tyrosine kinase inhibitors (TKI).
MATERIALS AND METHODS
We retrospectively reviewed 547 patients with mRCC who were diagnosed and treated with a first-line TKI between 2007 and 2015. The primary endpoint was overall survival (OS) and secondary endpoint was progression-free survival (PFS). We evaluated differences in survival outcomes according to SIR and identified predictors of OS and PFS.
RESULTS
In synchronous mRCC, patients with a higher PLR had significantly worse OS and PFS. Moreover, a higher NLR was also associated with both worse OS and PFS in these patients. However, PLR was not associated with either OS or PFS in metachronous mRCC patients. While metachronous mRCC patients with a higher NLR had worse OS compared to those with lower NLR, there was no difference in PFS according to the status of NLR. On multivariate analysis, PLR was identified as predictive factor for OS (hazard ratio [HR], 1.55) as well as PFS (HR, 1.39) in patients with synchronous mRCC, but not in patients with metachronous mRCC. Additionally, higher NLR was also remained as predictive factor of both OS (HR, 1.83) and PFS (HR, 1.57) in patients with synchronous mRCC.
CONCLUSIONS
Our study indicates that simple biomarkers of SIR, particularly PLR and NLR, can be more useful predictors of survival outcomes in patients with synchronous mRCC rather than metachronous mRCC.

Keyword

Metastatic renal cell carcinoma; Metachronous; Prognosticator; Synchronous; Systemic inflammatory response; Tyrosine kinase inhibitor

MeSH Terms

Biomarkers
Carcinoma, Renal Cell*
Disease-Free Survival
Humans
Multivariate Analysis
Protein-Tyrosine Kinases*
Retrospective Studies
Tyrosine*
Biomarkers
Protein-Tyrosine Kinases
Tyrosine