POSTOPERATIVE HIGH NEUTROPHIL-LYMPHOCYTE RATIO PREDICTS SURVIVAL IN RENAL CELL CARCINOMA

Objective: The neutrophil-lymhocyte ratio (NLR) has been used as a marker of systemic inflammatory response and various studies confirmed it affects overall survival in renal cell carcinom (RCC). Most studies used NLR as a poor prognostic factor when assesed preoperatively. The aim of our study is to demonstrate the postoperative NLR as a poor prognostic factor.Material and Methods: We reviewed 135 patients with RCC who were treated and followed in Kocaeli Univercity Medical Oncology Department between 2003 and 2014. Overall survival and progression free survival were assesed by using Kaplan-Maier method and prognostic significance of NLR and other independent factors were assesed by using cox regression models.Results: Univariate and multivariate analyses showed that T stage (HR:1.86; 95% Cl:1.2-2.5 p:0.003), hemoglobin count (HR:0.51; 95% Cl:0.34-0.76 p:0.001) and NLR (HR: 2.6; 95% Cl:1.1-5.5 p:0.017) as independent prognostic factors for overall survival. Conclusion: An increased NLR even after partial or radical nephrectomy can be a prognostic marker for RCC. In addition to recent studies which found preoperative NLR is a poor prognostic factor in RCC, we found postoperative NLR has a significance in overall survival.

Anahtar Kelimeler:

Neutrophil lymphocyte ratio, renal cell carcinom, survival

Yüksek Nötrofil- Lenfosit Oranının Renal Hücreli Karsinomda Preoperatif ve Postoperatif Dönemde Sağkalıma Etkisi

Amaç: Nötrofil-lenfosit oranı (NLO) sistemik inflamatuar yanıtı gösteren belirteçlerden biridir ve birçok çalışma renal hücreli karsinomda (RHK) genel sağkalımı etkilediğini ispatlamıştır. Yapılmış çalışmalarda NLO genellikle nefrektomi öncesi bakılmış ve kötü prognostik faktör olarak değerlendirilmiştir. Bu çalışmada postoperatif NLO’nun prognostik önemini göstermeyi amaçladık.Gereç ve Yöntemler: 2003 ile 2014 tarihleri arasında Kocaeli Üniversitesi Medikal Onkoloji kliniğinde takip ve tedavi olan 135 hasta geriye dönük olarak incelendi. Genel sağkalım ve progresyonsuz sağkalım Kaplan-Maier metoduyla NLO ve diğer bağımsız değişkenlerin prognostik önemi cox regresyon modeliyle hesaplandı.Bulgular: Univariete ve multivariete analizlerde T evresi (HR:1.86; %95 Cl:1.2-2.5 p:0.003), hemoglobin seviyesi (HR:0.51; %95 Cl:0.34-0.76 p:0.001) ve preoperatif NLO (HR:2.6; %95 Cl:1.1-5.5 p:0.017) RHK hastalarında genel sağkalımı etkileyen bağımsız faktörler olarak görüldü. Sonuç: Parsiyel ya da radikal nefrektomi yapılmış RHK hastalarında artmış NLO oranı prognostik belirteç olarak kullanılabilir. Geçmiş çalışmalarda preoperatif NLO yüksekliğinin öneminin vurgulanmasına ek olarak çalışmamızla postoperatif NLO seviyesinin önemi gösterilmiştir.

Keywords:

Nötrofil lenfosit oranı, renal hücreli karsinom, sağkalım,

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