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

Table 4

Multivariate analyses predicting probability of cancer-specific death in relation to the neutrophil-to-lymphocyte ratio in patients with nonmetastatic renal cell carcinoma.

Variables	NLR as a continuous variable			NLR as a categorical variable
	HR	95% CI	value	HR	95% CI	value
Age	1.042	1.016–1.069	0.002	1.044	1.018–1.072	0.001
Gender
Female versus male	0.652	0.324–1.313	0.231	0.648	0.323–1.300	0.222
BMI	0.916	0.832–1.009	0.074	0.924	0.840–1.017	0.105
ECOG PS
≥1 versus 0	2.820	1.498–5.309	0.001	2.672	1.408–5.071	0.003
Symptoms at presentation	1.029	0.558–1.897	0.927	1.056	0.577–1.932	0.860
Tumor size	1.012	1.002–1.022	0.015	1.012	1.002–1.022	0.018
T stage			0.022			0.020
T2 versus T1	0.665	0.198–2.233	0.509	0.662	0.198–2.215	0.503
T3-4 versus T1	2.175	1.025–4.617	0.043	2.209	1.041–4.688	0.039
Fuhrman’s grade
G3-4 versus G1-2	2.155	1.141–4.072	0.018	2.101	1.110–3.977	0.023
Histologic subtype			0.854			0.860
pRCC versus cRCC	1.268	0.551–2.919	0.576	1.257	0.554–2.850	0.584
chRCC versus cRCC	0.001	<0.001–5.496	0.959	0.001	<0.001–6.687	0.962
Sarcomatoid differentiation	3.355	1.230–9.148	0.018	3.092	1.123–8.514	0.029
Tumor necrosis	1.054	0.509–2.181	0.888	1.097	0.537–2.242	0.799
NLR
(1) Continuous	1.156	1.037–1.289	0.009
(2) High versus low NLR				2.566	1.348–4.887	0.004

NLR, neutrophil-to-lymphocyte ratio; low NLR, <3.7; high NLR, ≥3.7; BMI, body mass index; ECOG PS, Eastern Cooperative Oncology Group performance status; cRCC, clear cell renal cell carcinoma; pRCC, papillary renal cell carcinoma; chRCC, chromophobe renal cell carcinoma; HR, hazard ratio; CI, confidence interval.