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Preoperative Neutrophil Lymphocyte Ratio as a Prognostic Factor for Survival in Non-metastatic Renal Cell Carcinoma

Medical Oncology Unit, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 1Division of Urology, Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand

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Division of Urology, Department of Surgery, Faculty of Medicine, Khon Kaen University, Thailand, E-mail:

The purpose of this study was to determine the prognostic role of preoperative neutrophil lymphocyte ratio in non-metastatic renal cell carcinoma. This retrospective study included 89 non-metastatic renal cell carcinoma patients who underwent nephrectomy between 2007 and 2017. The cut-off value of neutrophil lymphocyte ratio was determined on the basis of receiver operating characteristic analysis. Univariable and multivariable Cox regression models were performed. At a median follow-up of 6.7 y, 29 patients (34 %) had died. The cut-off value for neutrophil lymphocyte ratio was 2.5 by receiver operating characteristic analysis, with the area under the curve value of 0.77. High neutrophil lymphocyte ratio was associated with high T stage (p=0.024). Elevated neutrophil lymphocyte ratio (>2.5) was significantly associated with low overall survival. Multivariable analysis revealed that high preoperative neutrophil lymphocyte ratio was an independent risk factors for overall survival (hazard ratio 5.54, 95 % confidence interval- 1.06-28.95, p=0.043), along with age >65 (p=0.001) and large tumor size (p<0.001). Preoperative neutrophil lymphocyte ratio is an independent prognostic factor for low overall survival in patients with non-metastatic renal cell carcinoma undergoing nephrectomy.

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