@Article{,
AUTHOR = {Wassim M. Bazzi, Amy L. Tin, Daniel D. Sjoberg, 
Melanie Bernstein, Paul Russo},
TITLE = {The prognostic utility of preoperative neutrophil-to-lymphocyte ratio in localized clear cell renal cell carcinoma},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {23},
YEAR = {2016},
NUMBER = {1},
PAGES = {8151--8154},
URL = {http://www.techscience.com/CJU/v23n1/61189},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> To explore whether the association between 
preoperative neutrophil-to-lymphocyte ratio (NLR) 
elevation and worse survival is of use prognostically or 
merely a reflection of medical comorbidities in clear cell 
renal cell carcinoma (CC RCC). <br/>
<b>Materials and methods:</b> We identified 1970 patients 
treated at Memorial Sloan Kettering Cancer Center from 
1998-2012 by partial or radical nephrectomy for nonmetastatic CC RCC. NLR was calculated by dividing 
absolute neutrophil count by absolute lymphocyte 
count; both were obtained from preoperative complete 
blood count. Uni- and multivariable Cox proportional 
hazards regression, which included established prognostic 
variables, were used to test for association between NLR 
and recurrence-free (RFS), cancer-specific (CSS), and 
overall survival (OS).<br/>
<b>Results:</b> Univariate analysis identified elevated NLR as 
significantly associated with worse RFS, CSS, and OS 
(all p < 0.0001). However, upon multivariable analysis, 
elevated NLR was significantly associated with only worse 
OS (p < 0.0001). After adding markers of comorbidity that 
were significantly correlated with NLR elevation—higher 
American Society of Anesthesiologists class (p = 0.013), 
older age, and higher estimated glomerular filtration rate 
(both p < 0.0001)—into the multivariable model, NLR 
remained significantly associated with OS (p = 0.001). The 
addition of NLR into the prognostic model for OS did not 
increase Harrell’s concordance index from 0.776.<br/>
<b>Conclusions:</b> In our cohort, preoperative NLR elevation 
is associated with worse OS, but there was no significant 
association with RFS or CSS on multivariable analysis. 
Preoperative NLR does not add unique prognostic 
information for patients undergoing surgical resection 
of renal tumors.},
DOI = {}
}