Prognostic Value of Hematologic Parameters in Patients with Metastatic Renal Cell Carcinoma Using Tyrosine Kinase Inhibitors

Abstract

<b>Background:</b> The prognostic significance of the neutrophil-to-lymphocyte ratio for progression free survivalin patients with metastatic renal cell carcinoma is unclear. Materials and <br/><b>Methods</b>: We retrospectively reviewed45 patients diagnosed with metastatic RCC previously treated with tyrosine kinase inhibitors from two centers,Akdeniz University Hospital and Afyon Kocatepe University. The prognostic value of the pretreatment neutrophiltolymphocyteratio, and other clinical and laboratory parameters were assessed by univariate and multivariateanalysis. <br/><b>Results</b>: Median progression free survival (PFS) was 13.9 months [95% CI for HR (6.88-20.91)] andoverall survival figure of 16.6 months [95% CI for HR (7.23-26.03)] Univariate analysis revealed that PFS wassignificantly affected by hemoglobin level [p=0.013 (95% CI for HR (0.71-0.96))], eosinophil count [p=0.031(95% CI for HR (0.20-0.92))], ratio of neutrophil lymphocytes (NLR) [p=0.007 (95% CI for HR (1.47-11.74))]and calcium level [p=0.006 (95% CI for HR (0.15-0.73))]. However, only NLR [p=0.031 (95% CI for HR (1.15-18.1))] and calcium levels [p=0.018 (95% CI for HR (0.20-18.1))] retained significance with multivariate analysis.Median PFS was 23.9 vs 8.6 months in patients with NLR ≤2 vs NLR >2 (Log rank; p= 0.040). <br/><b>Conclusions</b>: Thisstudy showed that increased pretreatment NLR is an independent prognostic factor for patients with metastaticRCC using tyrosine kinase inhibitors.