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BioMed Research International
Volume 2016, Article ID 5634148, 8 pages
Research Article

Prognostic Significance of Preoperative Neutrophil-to-Lymphocyte Ratio in Nonmetastatic Renal Cell Carcinoma: A Large, Multicenter Cohort Analysis

1Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea
2Department of Urology, College of Medicine, Chonnam National University, Gwangju, Republic of Korea
3Department of Urology, College of Medicine, Korea University, Seoul, Republic of Korea
4Department of Urology, College of Medicine, Catholic University, Seoul, Republic of Korea
5Department of Urology, National Cancer Center, Goyang, Republic of Korea
6Department of Urology, College of Medicine, Kyungpook National University, Daegu, Republic of Korea
7Department of Urology, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
8Department of Urology, College of Medicine, Hallym University, Chuncheon, Republic of Korea

Received 18 August 2016; Accepted 12 October 2016

Academic Editor: Péter Nyirády

Copyright © 2016 Seok-Soo Byun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) in nonmetastatic renal cell carcinoma (non-mRCC) is controversial, although NLR has been established as a prognostic factor in several cancers. The objective of our study was to assess the prognostic significance of preoperative NLR in non-mRCC, based on a large, multicenter cohort analysis. Methods. Totally, 1,284 non-mRCC patients undergoing surgery were enrolled from six institutions between 2000 and 2014. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were calculated, and the prognostic significance of NLR was evaluated. Results. Patients with higher NLR had larger tumors (), higher T stage (), worse Eastern Cooperative Oncology Group performance status (), worse symptoms (), sarcomatoid differentiation (), and tumor necrosis (). The 5-year RFS and CSS rates were significantly lower in patients with high NLR than in those with low NLR (each ). Multivariate analysis identified NLR to be an independent predictor of RFS and CSS (each ). Moreover, predictive accuracy of multivariate models for RFS and CSS increased by 2.2% and 4.2%, respectively, with NLR inclusion. Conclusions. Higher NLR was associated with worse clinical behavior of non-mRCC. Also, NLR was a significant prognostic factor of both RFS and CSS.