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KMID : 1011820200610050475
Investigative and Clinical Urology
2020 Volume.61 No. 5 p.475 ~ p.481
The platelet-to-lymphocyte ratio as a significant prognostic factor to predict survival outcomes in patients with synchronous metastatic renal cell carcinoma
Yuk Hyeong-Dong

Kang Min-Yong
Hwang Eu-Chang
Park Jae-Young
Jeong Chang-Wook
Song Che-Ryn
Seo Seong-Il
Byun Seok-Soo
Kwak Cheol
Hong Sung-Hoo
Chung Jin-Soo
Lee Hak-Min
Abstract
Purpose: The clinical impact of the platelet-to-lymphocyte ratio (PLR) on the prognosis of patients with metastatic renal cell carcinoma (mRCC) remains controversial. We investigated the associations between elevation of the PLR and disease prognosis in patients with synchronous mRCC.

Materials and Methods: The data of 1,505 patients with synchronous mRCC were retrospectively analyzed. The entire cohort was stratified into two subgroups according to PLR. Kaplan?Meier and Cox proportional analyses were performed to investigate the possible associations between the PLR and disease prognosis.

Results: There were 921 patients with a high PLR and 584 patients with a low PLR by use of the cutoff of 146. The patients with a high PLR had worse clinical characteristics in terms of advanced clinical stage (p<0.001) and rate of lymph node invasion (p=0.036). The Kaplan?Meier analysis showed that patients with a high PLR had significantly shorter overall survival (OS) (p<0.001) and cancer-specific survival (CSS) (p<0.001). The multivariate Cox analysis revealed that the PLR was an independent predictor for shorter OS (hazard ratio [HR], 1.345; 95% confidence interval [CI], 1.183?1.530; p<0.001) and CSS (HR, 1.318; 95% CI, 1.156?1.502; p<0.001). In the subgroup analyses, the PLR showed a significant association with survival outcomes in the subgroup with clear cell type (all p<0.05) but not in the subgroup with the non?clear cell type.

Conclusions: The PLR was an independent prognostic factor for survival outcomes in patients with mRCC. However, the association was statistically significant only in patients with clear cell type mRCC.
KEYWORD
Biomarkers, Blood platelets, Kidney neoplasms, Lymphocytes, Neoplasm metastasis
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