The combination of preoperative platelet count and neutrophil lymphocyte ratio as a prognostic indicator in localized renal cell carcinoma
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Takuya Tsujino1, Kazumasa Komura1,2, Atsushi Ichihashi1, Takeshi Tsutsumi1, Tomohisa Matsunaga1, Yuki Yoshikawa1, Ryoichi Maenosono1, Kyohei Okita1, Tomoaki Takai1, Rintaro Oide3, Koichiro Minami1, Hirofumi Uehara1, Kohei Taniguchi2,4, Hajime Hirano1, Hayahito Nomi1, Naokazu Ibuki1, Kiyoshi Takahara1, Teruo Inamoto1 and Haruhito Azuma1
1Department of Urology, Osaka Medical College, Osaka 569-8686, Japan
2Translational Research Program, Osaka Medical College, Osaka 569-8686, Japan
3Department of Biological Fundamental Research, Osaka Medical College, Osaka 569-8686, Japan
4Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka 569-8686, Japan
Kazumasa Komura, email: firstname.lastname@example.org
Keywords: renal cell carcinoma; COP-NLR; NLR; platelet; systemic inflammatory response
Received: September 11, 2017 Accepted: October 28, 2017 Published: November 25, 2017
Introduction: The combination of platelet count and neutrophil to lymphocyte ratio (COP-NLR) has been shown to provide prognostic information in several cancers, whereas its prognostic value in renal cell carcinoma (RCC) has not been reported. The objective of the present study was to examine the preoperative prognostic value of the COP-NLR in patients with localized RCC undergoing nephrectomy.
Material and Methods: The record of 268 patients, who underwent nephrectomy due to a diagnosis of RCC at our institute was analyzed in the study. The cut-off value of platelet count and NLR were defined by receive operating characteristic (ROC) analysis and the areas under the curve (AUC). Patients with both an increased platelet count (> 310×109/l) and an elevated NLR (> 3.85) were assigned to the score 2, and patients with one or neither of these indicators were assigned to the score 1 or 0, respectively. The impact of the COP-NLR and other clinicopathological characteristics on overall survival (OS) and recurrence-free survival (RFS) were evaluated using the univariate and multivariate Cox regression analysis.
Result: The median follow-up duration after surgical resection was 60 months. Multivariate analysis using the 10 clinicopathological findings selected by univariate analyses demonstrated that the preoperative COP-NLR was an independent prognostic factor for OS (HR: 2.32, 95%CI: 1.22 to 4.26, p=0.011) and RFS (HR: 1.91, 95%CI: 1.02 to 3.53, p=0.044).
Conclusion: The findings of the current study suggested that the preoperative COP-NLR is an independent prognostic indicator of OS and RFS for patients with localized RCC.
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