Comparison of the prognostic value of pretreatment measurements of systemic inflammatory response in patients undergoing curative resection of clear cell renal cell carcinoma.

Détails

ID Serval
serval:BIB_62D2B7FA1B22
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Comparison of the prognostic value of pretreatment measurements of systemic inflammatory response in patients undergoing curative resection of clear cell renal cell carcinoma.
Périodique
World Journal of Urology
Auteur(s)
Lucca I., de Martino M., Hofbauer S.L., Zamani N., Shariat S.F., Klatte T.
ISSN
1433-8726 (Electronic)
ISSN-L
0724-4983
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
33
Numéro
12
Pages
2045-2052
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
PURPOSE: Pretreatment measurements of systemic inflammatory response, including the Glasgow prognostic score (GPS), the neutrophil-to-lymphocyte ratio (NLR), the monocyte-to-lymphocyte ratio (MLR), the platelet-to-lymphocyte ratio (PLR) and the prognostic nutritional index (PNI) have been recognized as prognostic factors in clear cell renal cell carcinoma (CCRCC), but there is at present no study that compared these markers.
METHODS: We evaluated the pretreatment GPS, NLR, MLR, PLR and PNI in 430 patients, who underwent surgery for clinically localized CCRCC (pT1-3N0M0). Associations with disease-free survival were assessed with Cox models. Discrimination was measured with the C-index, and a decision curve analysis was used to evaluate the clinical net benefit.
RESULTS: On multivariable analyses, all measures of systemic inflammatory response were significant prognostic factors. The increase in discrimination compared with the stage, size, grade and necrosis (SSIGN) score alone was 5.8 % for the GPS, 1.1-1.4 % for the NLR, 2.9-3.4 % for the MLR, 2.0-3.3 % for the PLR and 1.4-3.0 % for the PNI. On the simultaneous multivariable analysis of all candidate measures, the final multivariable model contained the SSIGN score (HR 1.40, P < 0.001), the GPS (HR 2.32, P < 0.001) and the MLR (HR 5.78, P = 0.003) as significant variables. Adding both the GPS and the MLR increased the discrimination of the SSIGN score by 6.2 % and improved the clinical net benefit.
CONCLUSIONS: In patients with clinically localized CCRCC, the GPS and the MLR appear to be the most relevant prognostic measures of systemic inflammatory response. They may be used as an adjunct for patient counseling, tailoring management and clinical trial design.
Mots-clé
Aged, Blood Cell Count, Carcinoma, Renal Cell/diagnosis, Carcinoma, Renal Cell/mortality, Disease-Free Survival, Female, Humans, Inflammation/diagnosis, Inflammation/etiology, Kidney Neoplasms/diagnosis, Kidney Neoplasms/mortality, Male, Middle Aged, Nephrectomy, Nutrition Assessment, Prognosis, Proportional Hazards Models, Retrospective Studies
Pubmed
Web of science
Création de la notice
03/01/2016 17:28
Dernière modification de la notice
20/08/2019 15:19
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