Prognostic significance of platelet-lymphocyte ratio in patients receiving first-line tyrosine kinase inhibitors for metastatic renal cell cancer

The platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) have been reported as prognostic factors in various cancers, but their roles in metastatic renal cell cancer (mRCC) remain unclear. We investigated the significance of PLR and NLR, along with that of established prognostic factors, in mRCC patients receiving first-line tyrosine kinase inhibitors (TKI).

Data obtained from 63 mRCC patients who received first-line TKI between 2007 and 2013 were evaluated retrospectively. The association of PLR, NLR, and established prognostic factors with progression-free survival (PFS) and overall survival (OS) was analyzed using the Kaplan-Meier method. The influence of independent prognostic factors on survival was determined using multivariable Cox regression analysis.

High NLR (>3.6) and PLR (>150) were related to shorter PFS (p = 0.001) and OS (p = 0.001). The presence of brain metastases [hazard ratio (HR) 4.94, 95% CI 1.75-13.9; p = 0.002] and high PLR (>150, HR 13.1, 95% CI 5.14-33.2; p = 0.001) were independently associated with PFS, and Eastern Cooperative Oncology Group Performance status ≥2 (HR 3.60, 95% CI 1.39-9.31; p = 0.008), lymph node metastasis (HR 2.76, 95% CI 1.11-6.86; p = 0.029), brain metastasis (HR 9.39, 95% CI 2.74-32.1; p = 0.001), and high PLR (>150, HR 16.1, 95% CI 4.41-58.4; p = 0.001) with OS.

High PLR was associated with shorter survival of mRCC patients receiving first-line TKI. The PLR may be an effective independent prognostic factor in this setting.

SpringerPlus. 2016 Oct 28*** epublish ***

Tae Ju Park, Yang Hyun Cho, Ho Seok Chung, Eu Chang Hwang, Sung-Hoon Jung, Jun Eul Hwang, Woo Kyun Bae, Jin Woong Kim, Suk Hee Heo, Young Hoe Hur, Seung Il Jung, Dong Deuk Kwon

Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea., Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea., Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea., Department of Hepato-Pancreato-Biliary Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea.