The Prognostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Small Renal Cell Carcinomas after Image-Guided Cryoablation or Radio-Frequency Ablation

Author:

Asif Aqua12ORCID,Chan Vinson Wai-Shun234ORCID,Osman Filzah Hanis5ORCID,Koe Jasmine Sze-Ern6,Ng Alexander27ORCID,Burton Oliver Edward8ORCID,Cartledge Jon9,Kimuli Michael9,Vasudev Naveen10,Ralph Christy10,Jagdev Satinder10,Bhattarai Selina11,Smith Jonathan12,Lenton James12ORCID,Wah Tze Min312ORCID

Affiliation:

1. Royal Surrey NHS Foundation Trust, Surrey GU2 7XX, UK

2. Division of Surgery and Interventional Science, University College London, London WC1E 6BT, UK

3. Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK

4. Royal Derby Hospital, University Hospitals of Derby and Burton NHS Foundation Trust, Derby DE22 3NE, UK

5. School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK

6. Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield S44 5BL, UK

7. Royal Free London NHS Foundation Trust, London NW3 2QG, UK

8. School of Medical Education, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK

9. Department of Urology, St. James’s University Hospital, Leeds LS9 7TF, UK

10. Department of Medical Oncology, St. James’s University Hospital, Leeds LS9 7TF, UK

11. Department of Pathology, St. James’s University Hospital, Leeds LS9 7TF, UK

12. Department of Diagnostic and Interventional Radiology, Institute of Oncology, Leeds Teaching Hospitals Trust, St. James’s University Hospital, Leeds LS9 7TF, UK

Abstract

There is a lack of cheap and effective biomarkers for the prediction of renal cancer outcomes post-image-guided ablation. This is a retrospective study of patients with localised small renal cell cancer (T1a or T1b) undergoing cryoablation or radiofrequency ablation (RFA) at our institution from 2003 to 2016. A total of 203 patients were included in the analysis. In the multivariable analysis, patients with raised neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) pre-operatively, post-operatively and peri-operatively are associated with significantly worsened cancer-specific survival, overall survival and metastasis-free survival. Furthermore, an increased PLR pre-operatively is also associated with increased odds of a larger than 25% drop in renal function post-operatively. In conclusion, NLR and PLR are effective prognostic factors in predicting oncological outcomes and peri-operative outcomes; however, larger external datasets should be used to validate the findings prior to clinical application.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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