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Predictive value of preoperative monocyte-lymphocyte ratio among patients with localized clear renal cell carcinoma of ≤7 cm on preoperative imaging

Authors
 Ahmed Elghiaty  ;  Jongchan Kim  ;  Won Sik Jang  ;  Jee Soo Park  ;  Ji Eun Heo  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Won Sik Ham 
Citation
 Medicine, Vol.97(48) : e13433, 2018 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2018
MeSH
Adult ; Aged ; Biomarkers, Tumor/blood ; Carcinoma, Renal Cell/blood* ; Carcinoma, Renal Cell/immunology ; Carcinoma, Renal Cell/mortality ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Kidney Neoplasms/blood* ; Kidney Neoplasms/immunology ; Kidney Neoplasms/mortality ; Lymphocyte Count ; Lymphocytes* ; Male ; Middle Aged ; Monocytes* ; Neoplasm Recurrence, Local/blood ; Neoplasm Recurrence, Local/immunology ; Neoplasm Recurrence, Local/mortality ; Predictive Value of Tests ; Preoperative Period ; Proportional Hazards Models ; Retrospective Studies
Abstract
We investigated the prognostic ability of preoperative monocyte-lymphocyte ratio for oncologic outcomes in non-metastatic clear cell renal cell carcinoma of ≤7 cm on preoperative computed tomography (CT).We retrospectively reviewed 1637 patients who underwent radical or partial nephrectomy for solid renal masses ≤7 cm (2005-2014). We included 1137 patients after exclusion of benign pathology, non-clear cell, morbidity affecting inflammatory markers, metastasis, regional lymphadenopathy, positive margin, and follow up <12 months. According to cutoff values of 0.21, we had high ≥0.21 and low <0.21 preoperative monocyte-lymphocyte ratio groups. Mann-Whitney U and chi-squared tests were used for continuous and Dichotomous variables. Univariate and multivariate Cox regression analysis were used to predict factors affecting recurrence and survival. Kaplan-Meier curve was used for survival analysis.At a median age of 56 years with a median follow up of 65 months, 51 patients had a recurrence (4.5%). There were no statistical differences between the high and low monocyte-lymphocyte ratio groups as regard the pathological characters (P > .005). Monocyte-lymphocyte ratio was a predictor for recurrence-free and cancer-specific survivals (hazard risk [HR] 2.17, P = .012 and HR 4.06, P = .004, respectively). A higher monocyte-lymphocyte ratio was significantly associated with worse, both 10-year recurrence-free (90.2% vs 94.9%) and cancer-specific survival (89.5% vs 98.8%) (Log-rank, P = .002 and P < .001, respectively).The preoperative monocyte-lymphocyte ratio is an independent prognostic marker for recurrence-free and cancer-specific survivals after curative surgery for non-metastatic clear cell renal cell carcinoma of ≤7 cm on preoperative CT.
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DOI
10.1097/MD.0000000000013433
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
김종찬(Kim, Jong Chan) ORCID logo https://orcid.org/0000-0002-0022-6689
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
박지수(Park, Jee Soo) ORCID logo https://orcid.org/0000-0001-9976-6599
장원식(Jang, Won Sik) ORCID logo https://orcid.org/0000-0002-9082-0381
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
함원식(Ham, Won Sik) ORCID logo https://orcid.org/0000-0003-2246-8838
허지은(Heo, Ji Eun) ORCID logo https://orcid.org/0000-0002-4184-8468
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166795
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