Doaa Atef Soliman1
1Clinical Oncology Department, Ain Shams University Hospital, Egypt
ABSTRACT
Background: Treatment and prognosis of patients with mRCC have been improved by understanding molecular pathogenesis. Several prognostic models based on the data of patients treated with targeted therapy and immunotherapy have been useful in clinical practice. Serum blood markers related to inflammatory response have been reported to be associated with their prognosis or prediction of therapeutic efficacy. Study design and Methodology: Neutrophil/lymphocyte ratio (NLR) was estimated in thirty-two patients with pathological confirmed mRCC as baseline and after two months of systemic therapy. NLR failure was defined as an increase of 3 or more compared to baseline NLR. Results: Thirty-two patients were enrolled with a mean age 62.7 years and male gender predominance (81.2%). Twenty-seven patients had clear cell pathological subtype. Neutrophil/lymphocyte ratio (NLR) mean value baseline was 3.17 and after 2 months of treatment was 5.88. Pazopanib was the commonest received treatment (50%). Six patient (18.8%) had progressed after 2 months of first line of treatment. By the end of the study, only 2 patients were still alive. Mean disease-free survival (DFS) for patients presented with non-metastatic disease 16 months. Mean overall survival (OS) for all patients was 18 months. NPL difference change before and after 2 months of treatment, revealed that patients with lower NLR change had a statistically significant better OS than patients with high NLR change (p< 0.0001). Cutoff value of NLR 3.6. Conclusion: NLR is a prognostic marker in patients with mRCC with predictive role in response to treatment on survival rate.
Keywords:Renal Cell Carcinoma, Neutrophil/Lymphocyte Ratio, Prognosis.