Objective:
We aimed to investigate the prognostic significance of the preoperative platelet-to-lymphocyte ratio (PLR) in a cohort of clinically non-metastatic renal cell carcinoma (RCC).
Material and Methods:
We evaluated a retrospective analysis of 298 patients who underwent radical or partial nephrectomy for RCC between 2006 and 2015. The optimal cutoff value for the PLR was calculated using receiver operating curce (ROC) analysis. The prognostic value of PLR was determined by Kaplan-Meier curve, univariable and multivariable Cox regression models.
Results:
The optimal cut-off level was 200 (AUC=0.715; sensitivity, 52.4%; specificity, 90.6%) for PLR by ROC curve analysis and elevated PLR was significantly correlated with worse cancer-specific survival (CSS). Multivariable analysis showed that elevated PLR was an independent risk factor for CSS (HR, 3.460; 95% CI, 1.691-7.081; p=0.001). A high PLR was also significantly correlated with aggressive tumor behaviors. Subgroup analysis revealed significant associations of the elevated PLR on CSS for both clear cell and non-clear cell RCC types (p<0.001).
Conclusion:
The PLR is an independent prognostic factor for CSS after treatment with curative intent for clinically localized clear cell and non-clear cell RCC. PLR may provide a significant adjunct for clinical trial design and risk stratifying patients for localized RCC.
Keywords: lymphocytes, platelets, prognosis, renal cell carcinoma, survival