The prognostic value of the neutrophil-lymphocyte ratio in renal oncology: A review

- The neutrophil-lymphocyte ratio (NLR) is a biological marker of inflammation.
- For localized RCC, an NLR<3 was predictive of a reduced risk of recurrence.
- An NLR<3 predicted increased overall survival and progression-free survivals.
- The prognostic value of the NLR was stronger for metastatic/locally advanced RCC.

BackgroundThe neutrophil-lymphocyte ratio (NLR) is a biological marker of inflammation with a significant prognostic value in the field of oncology.AimIn this review, we discuss the prognostic value of the NLR in renal cell carcinoma (RCC).Material and MethodWe conducted a literature review of the PubMed database in August 2016. Initial research identified 31 publications. Following full-text screening, 15 studies were finally included: 7 studies concerning metastatic or locally advanced renal cancer, 6 studies dealing with localized renal cancer, 2 articles evaluating the NLR in renal cancer whatever the status of the disease (metastatic or localized).ResultsFor localized RCC, an NLR o 3 was predictive of a reduced risk of recurrence (hazard ratio ¼ 1.63 [1.15, 2.29]). The prognostic value of the NLR was stronger for metastatic or locally advanced RCC. An NLR o 3 predicted increased overall survival (hazard ratio ¼ 1.55 [1.36, 1.76]), progression-free survivals (hazard ratio ¼ 3.19 [2.23, 4.57]), and a response to systemic treatment.ConclusionIn current practice, the NLR is a simple and inexpensive prognostic factor with potential improvement in the prognostic performance of nomograms used in renal oncology.