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자료유형
학술저널
저자정보
김태우 (아주대학교병원) 이정환 (아주대학교) 심강희 (아주대학교) 추설호 (아주대학교) 최종보 (아주대학교) 안현수 (아주대학교) 김세중 (아주대학교) 김선일 (아주대학교)
저널정보
대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.60 No.1
발행연도
2019.1
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14 - 20 (7page)

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Purpose: To evaluate the significance of preoperative and follow-up neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic factors for recurrence in patients with non-metastatic clear cell renal cell carcinoma (NMCCRCC). Materials and Methods: We retrospectively reviewed the medical records of 309 patients with NMCCRCC who underwent radical or partial nephrectomy. The prognostic significance of various clinicopathological variables, preoperative NLR (pNLR) and PLR (pPLR), and NLR and PLR at recurrence or quasi-recurrence (rNLR and rPLR) for recurrence-free survival (RFS) was analyzed. Results: At mean follow-up of 93 months, 44 patients (14.2%) developed recurrence. In the univariate analysis, clinical presentation, tumor size, pathologic tumor stage, Fuhrman grade, pNLR, pPLR and rNLR were significant prognostic factors for RFS. In the multivariate analysis using pNLR and pPLR as continuous variables, tumor size, pathologic tumor stage and pPLR were independent prognostic factors for RFS. In the multivariate analysis using pNLR and pPLR as dichotomous variables, tumor size, pathologic tumor stage, Fuhrman grade and pNLR ≥1.7 were independent prognostic factors for RFS. In multivariate analyses using rNLR and rPLR, only tumor size and pathologic tumor stage were independent prognostic factors for RFS. In a subset of patients with recurrence or at least 42 months follow-up without recurrence, rNLR ≥1.9 was significantly associated with worse RFS, albeit without independent significance. Conclusions: pNLR and pPLR are independent prognostic factors for RFS in patients with NMCCRCC. We propose that postoperative follow-up NLR of 1.9 and higher with one or more adverse clinicopathological factors should prompt radiologic evaluation for possible metastasis.

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