
Prognostic value of the neutrophil‑to‑lymphocyte ratio in renal cell carcinoma: A systematic review and meta‑analysis
- Authors:
- Kecheng Lou
- Xin Cheng
-
Affiliations: Department of Urology, Lanxi People's Hospital, Jinhua, Zhejiang 321100, P.R. China, Department of Urology, Ganzhou Cancer Hospital of Gannan Medical University, Ganzhou, Jiangxi 341000, P.R. China - Published online on: March 13, 2025 https://doi.org/10.3892/ol.2025.14977
- Article Number: 231
-
Copyright: © Lou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
This article is mentioned in:
Abstract
![]() |
![]() |
![]() |
![]() |
![]() |
Siegel RL, Miller KD and Jemal A: Cancer statistics, 2018. CA Cancer J Clin. 68:7–30. 2018. View Article : Google Scholar : PubMed/NCBI | |
Siegel RL, Miller KD and Jemal A: Cancer statistics, 2019. CA Cancer J Clin. 69:7–34. 2019. View Article : Google Scholar : PubMed/NCBI | |
Capitanio U and Montorsi F: Renal cancer. Lancet. 387:894–906. 2016. View Article : Google Scholar : PubMed/NCBI | |
Motzer RJ, Jonasch E, Agarwal N, Bhayani S, Bro WP, Chang SS, Choueiri TK, Costello BA, Derweesh IH, Fishman M, et al: Kidney cancer, version 2.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 15:804–834. 2017. View Article : Google Scholar : PubMed/NCBI | |
Yang JC and Childs R: Immunotherapy for renal cell cancer. J Clin Oncol. 24:5576–5583. 2006. View Article : Google Scholar : PubMed/NCBI | |
Simonaggio A, Elaidi R, Fournier L, Fabre E, Ferrari V, Borchiellini D, Thouvenin J, Barthelemy P, Thibault C, Tartour E, et al: Variation in neutrophil to lymphocyte ratio (NLR) as predictor of outcomes in metastatic renal cell carcinoma (mRCC) and non-small cell lung cancer (mNSCLC) patients treated with nivolumab. Cancer Immunol Immunother. 69:2513–2522. 2020. View Article : Google Scholar : PubMed/NCBI | |
Shang B, Guo L, Shen R, Cao C, Xie R, Jiang W, Wen L, Bi X, Shi H, Zheng S, et al: Prognostic significance of NLR about NETosis and lymphocytes perturbations in localized renal cell carcinoma with tumor thrombus. Front Oncol. 11:7715452021. View Article : Google Scholar : PubMed/NCBI | |
Boissier R, Campagna J, Branger N, Karsenty G and Lechevallier E: The prognostic value of the neutrophil-lymphocyte ratio in renal oncology: A review. Urol Oncol. 35:135–141. 2017. View Article : Google Scholar : PubMed/NCBI | |
Hu H, Yao X, Xie X, Wu X, Zheng C, Xia W and Ma S: Prognostic value of preoperative NLR, dNLR, PLR and CRP in surgical renal cell carcinoma patients. World J Urol. 35:261–270. 2017. View Article : Google Scholar : PubMed/NCBI | |
Rao Z, Zhu Y, Yang P, Chen Z, Xia Y, Qiao C, Liu W, Deng H, Li J, Ning P and Wang Z: Pyroptosis in inflammatory diseases and cancer. Theranostics. 12:4310–4329. 2022. View Article : Google Scholar : PubMed/NCBI | |
Lee HM, Lee HJ and Chang JE: Inflammatory cytokine: An attractive target for cancer treatment. Biomedicines. 10:21162022. View Article : Google Scholar : PubMed/NCBI | |
Sharma N and Jha S: NLR-regulated pathways in cancer: Opportunities and obstacles for therapeutic interventions. Cell Mol Life Sci. 73:1741–1764. 2016. View Article : Google Scholar : PubMed/NCBI | |
Li Y, Jia H, Yu W, Xu Y, Li X, Li Q and Cai S: Nomograms for predicting prognostic value of inflammatory biomarkers in colorectal cancer patients after radical resection. Int J Cancer. 139:220–231. 2016. View Article : Google Scholar : PubMed/NCBI | |
Li MX, Liu XM, Zhang XF, Zhang JF, Wang WL, Zhu Y, Dong J, Cheng JW, Liu ZW, Ma L and Lv Y: Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: A systematic review and meta-analysis. Int J Cancer. 134:2403–2413. 2014. View Article : Google Scholar : PubMed/NCBI | |
Gu X, Gao X, Li X, Qi X, Ma M, Qin S, Yu H, Sun S, Zhou D and Wang W: Prognostic significance of neutrophil-to-lymphocyte ratio in prostate cancer: Evidence from 16,266 patients. Sci Rep. 6:220892016. View Article : Google Scholar : PubMed/NCBI | |
Marchioni M, Primiceri G, Ingrosso M, Filograna R, Castellan P, De Francesco P and Schips L: The clinical use of the neutrophil to lymphocyte ratio (NLR) in urothelial cancer: A systematic review. Clin Genitourin Cancer. 14:473–484. 2016. View Article : Google Scholar : PubMed/NCBI | |
Saputra HM, Hidayatullah F, Kloping YP, Renaldo J, Chung E and Hakim L: Prognostic value of neutrophil-to-lymphocyte ratio (NLR) in penile cancer: A systematic review and meta-analysis. Ann Med Surg (Lond). 81:1043352022.PubMed/NCBI | |
Stares M, Ding TE, Stratton C, Thomson F, Baxter M, Cagney H, Cumming K, Swan A, Ross F, Barrie C, et al: Biomarkers of systemic inflammation predict survival with first-line immune checkpoint inhibitors in non-small-cell lung cancer. ESMO Open. 7:1004452022. View Article : Google Scholar : PubMed/NCBI | |
Tokumaru Y, Oshi M, Murthy V, Tian W, Yan L, Angarita FA, Nagahashi M, Matsuhashi N, Futamura M, Yoshida K, et al: Low intratumoral genetic neutrophil-to-lymphocyte ratio (NLR) is associated with favorable tumor immune microenvironment and with survival in triple negative breast cancer (TNBC). Am J Cancer Res. 11:5743–5755. 2021.PubMed/NCBI | |
Ouyang H, Xiao B, Huang Y and Wang Z: Baseline and early changes in the neutrophil-lymphocyte ratio (NLR) predict survival outcomes in advanced colorectal cancer patients treated with immunotherapy. Int Immunopharmacol. 123:1107032023. View Article : Google Scholar : PubMed/NCBI | |
Kobayashi T, Ito K, Kojima T, Maruyama S, Mukai S, Tsutsumi M, Miki J, Okuno T, Yoshio Y, Matsumoto H, et al: Pre-pembrolizumab neutrophil-to-lymphocyte ratio (NLR) predicts the efficacy of second-line pembrolizumab treatment in urothelial cancer regardless of the pre-chemo NLR. Cancer Immunol Immunother. 71:461–471. 2022. View Article : Google Scholar : PubMed/NCBI | |
Mandaliya H, Jones M, Oldmeadow C and Nordman II: Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): Neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI). Transl Lung Cancer Res. 8:886–894. 2019. View Article : Google Scholar : PubMed/NCBI | |
Grassadonia A, Graziano V, Iezzi L, Vici P, Barba M, Pizzuti L, Cicero G, Krasniqi E, Mazzotta M, Marinelli D, et al: Prognostic relevance of neutrophil to lymphocyte ratio (NLR) in luminal breast cancer: A retrospective analysis in the neoadjuvant setting. Cells. 10:16852021. View Article : Google Scholar : PubMed/NCBI | |
Hu X, Tian T, Zhang X, Sun Q, Chen Y and Jiang W: Neutrophil-to-lymphocyte and hypopharyngeal cancer prognosis: System review and meta-analysis. Head Neck. 45:492–502. 2023. View Article : Google Scholar : PubMed/NCBI | |
Chen S, Zhang L, Yan G, Cheng S, Fathy AH, Yan N and Zhao Y: Neutrophil-to-lymphocyte ratio is a potential prognostic biomarker in patients with ovarian cancer: A meta-analysis. Biomed Res Int. 2017:79434672017.PubMed/NCBI | |
Shao Y, Wu B, Jia W, Zhang Z, Chen Q and Wang D: Prognostic value of pretreatment neutrophil-to-lymphocyte ratio in renal cell carcinoma: A systematic review and meta-analysis. BMC Urol. 20:902020. View Article : Google Scholar : PubMed/NCBI | |
Allenet C, Klein C, Rouget B, Margue G, Capon G, Alezra E, Blanc P, Estrade V, Bladou F, Robert G and Bernhard JC: Can pre-operative neutrophil-to-lymphocyte ratio (NLR) help predict non-metastatic renal carcinoma recurrence after nephrectomy? (UroCCR-61 study). Cancers (Basel). 14:56922022. View Article : Google Scholar : PubMed/NCBI | |
Korkmaz M and Erylmaz MK: Systemic inflammatory markers predicting the overall survival of patients using tyrosine kinase inhibitors in the first-line treatment of metastatic renal cell carcinoma. J Coll Physicians Surg Pak. 33:653–658. 2023.PubMed/NCBI | |
Tucker MD, Brown LC, Chen YW, Kao C, Hirshman N, Kinsey EN, Ancell KK, Beckermann KE, Davis NB, McAlister R, et al: Association of baseline neutrophil-to-eosinophil ratio with response to nivolumab plus ipilimumab in patients with metastatic renal cell carcinoma. Biomark Res. 9:802021. View Article : Google Scholar : PubMed/NCBI | |
Cordeiro MD, Ilario EN, Abe DK, Carvalho PA, Muniz DQB, Sarkis AS, Coelho RF, Guimarães RM, Haddad MV and Nahas WC: Neutrophil-to-lymphocyte ratio predicts cancer outcome in locally advanced clear renal cell carcinoma. Clin Genitourin Cancer. 20:102–106. 2022. View Article : Google Scholar : PubMed/NCBI | |
Young M, Tapia JC, Szabados B, Jovaisaite A, Jackson-Spence F, Nally E and Powles T: NLR outperforms low hemoglobin and high platelet count as predictive and prognostic biomarker in metastatic renal cell carcinoma treated with immune checkpoint inhibitors. Clin Genitourin Cancer. 22:1020722024. View Article : Google Scholar : PubMed/NCBI | |
Asif A, Chan VWS, Osman FH, Koe JSE, Ng A, Burton OE, Cartledge J, Kimuli M, Vasudev N, Ralph C, et al: The prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for small renal cell carcinomas after image-guided cryoablation or radio-frequency ablation. Cancers (Basel). 15:21872023. View Article : Google Scholar : PubMed/NCBI | |
Edge SB and Compton CC: The American joint committee on cancer: The 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 17:1471–1474. 2010. View Article : Google Scholar : PubMed/NCBI | |
Lo CK, Mertz D and Loeb M: Newcastle-Ottawa Scale: Comparing reviewers' to authors' assessments. BMC Med Res Methodol. 14:452014. View Article : Google Scholar : PubMed/NCBI | |
Parmar MK, Torri V and Stewart L: Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med. 17:2815–2834. 1998. View Article : Google Scholar : PubMed/NCBI | |
Tierney JF, Stewart LA, Ghersi D, Burdett S and Sydes MR: Practical methods for incorporating summary time-to-event data into meta-analysis. Trials. 8:162007. View Article : Google Scholar : PubMed/NCBI | |
DerSimonian R and Laird N: Meta-analysis in clinical trials. Control Clin Trials. 7:177–188. 1986. View Article : Google Scholar : PubMed/NCBI | |
Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck-Ytter Y, Glasziou P, DeBeer H, et al: GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 64:383–394. 2011. View Article : Google Scholar : PubMed/NCBI | |
Parosanu AI, Baston C, Stanciu IM, Parlog CF and Nitipir C: Second-line treatment of metastatic renal cell carcinoma in the era of predictive biomarkers. Diagnostics (Basel). 13:24302023. View Article : Google Scholar : PubMed/NCBI | |
Parosanu AI, Pirlog CF, Slavu CO, Stanciu IM, Cotan HT, Vrabie RC, Popa AM, Olaru M, Iaciu C, Bratu LI, et al: The prognostic value of neutrophil-to-lymphocyte ratio in patients with metastatic renal cell carcinoma. Curr Oncol. 30:2457–2464. 2023. View Article : Google Scholar : PubMed/NCBI | |
Nagamoto S, Urakami S, Oka S, Ogawa K, Kono K, Sakaguchi K, Kinowaki K, Yamada D and Kume H: Impact of the neutrophil-to-lymphocyte ratio as a surgical prognostic factor in renal cell carcinoma with inferior-vena-cava tumor thrombus. Asian J Surg. 46:192–200. 2023. View Article : Google Scholar : PubMed/NCBI | |
Ni J, Wang Y, Zhang H, Wang K, Song W, Luo M, Che J, Geng J, Xu Y, Yao X, et al: Combination of preoperative plasma fibrinogen and neutrophil-to-lymphocyte ratio to predict the prognosis for patients undergoing laparoscopic nephrectomy for renal cell carcinoma. Am J Cancer Res. 12:3713–3728. 2022.PubMed/NCBI | |
Chaker K, Ouanes Y, Dali KM, Bibi M, Messaoudi Y, Mosbehi B, Abid K, Sellami A, Ben Rhouma S and Nouira Y: The prognostic value of preoperative neutrophil-to-lymphocyte ratio in patients with non-metastatic renal cell carcinoma. Prog Urol. 32:585–592. 2022.(In French). View Article : Google Scholar : PubMed/NCBI | |
Wang J, Ye J, Zhao X, Li X and Ma X: Prognostic value and model construction of preoperative inflammatory markers in patients with metastatic renal cell carcinoma. World J Surg Oncol. 21:2112023. View Article : Google Scholar : PubMed/NCBI | |
Wang Z, Qin Y, Chai X, Lu L, Xue P, Lu R, Miao C, Ma H, Hu X and Yao J: Systemic inflammatory biomarkers predict survival of patients treated with tyrosine kinase inhibitors for metastatic renal cell carcinoma. Cancer Control. 30:107327482311975112023. View Article : Google Scholar : PubMed/NCBI | |
Khan AI, Psutka SP, Patil DH, Hong G, Williams MA, Bilen MA, Sekhar A, Kissick HT, Narayan VM, Joshi SS, et al: Sarcopenia and systemic inflammation are associated with decreased survival after cytoreductive nephrectomy for metastatic renal cell carcinoma. Cancer. 128:2073–2084. 2022. View Article : Google Scholar : PubMed/NCBI | |
Cheng Y, Kou W and Zhu Y: Preoperative inflammation-associated blood cell markers in patients with non-metastatic clear cell renal cell carcinoma: A retrospective study. Int J Gen Med. 16:3067–3080. 2023. View Article : Google Scholar : PubMed/NCBI | |
Zhang Q, Song HF, Ma BL, Zhang ZN, Zhou CH, Li AL, Liu J, Liang L, Zhu SY and Zhang Q: Pre-operative prognostic nutritional index as a predictive factor for prognosis in non-metastatic renal cell carcinoma treated with surgery. Beijing Da Xue Xue Bao Yi Xue Ban. 55:149–155. 2023.(In Chinese). PubMed/NCBI | |
Anpalakhan S, Signori A, Cortellini A, Verzoni E, Giusti R, Aprile G, Ermacora P, Catino A, Pipitone S, Di Napoli M, et al: Using peripheral immune-inflammatory blood markers in tumors treated with immune checkpoint inhibitors: An INVIDIa-2 study sub-analysis. iScience. 26:1079702023. View Article : Google Scholar : PubMed/NCBI | |
Rebuzzi SE, Signori A, Buti S, Banna GL, Murianni V, Damassi A, Maruzzo M, Giannarelli D, Tortora G, Galli L, et al: Validation of the Meet-URO score in patients with metastatic renal cell carcinoma receiving first-line nivolumab and ipilimumab in the Italian expanded access program. ESMO Open. 7:1006342022. View Article : Google Scholar : PubMed/NCBI | |
Aslan V, Kılıç ACK, Sütcüoğlu O, Eraslan E, Bayrak A, Öksüzoğlu B, Tahtacı G, Özdemir N, Üner A, Günel N, et al: Cachexia index in predicting outcomes among patients receiving immune checkpoint inhibitor treatment for metastatic renal cell carcinoma. Urol Oncol. 40:494.e1–e10. 2022. View Article : Google Scholar : PubMed/NCBI | |
Ueda K, Suekane S, Kurose H, Ogasawara N, Hiroshige T, Chikui K, Uemura K, Nakiri M, Nishihara K, Matsuo M and Igawa T: Absolute lymphocyte count is an independent predictor of survival in patients with metastatic renal cell carcinoma treated with nivolumab. Jpn J Clin Oncol. 52:179–186. 2022. View Article : Google Scholar : PubMed/NCBI | |
Singh N, Baby D, Rajguru JP, Patil PB, Thakkannavar SS and Pujari VB: Inflammation and cancer. Ann Afr Med. 18:121–126. 2019. View Article : Google Scholar : PubMed/NCBI | |
Mierke CT: The fundamental role of mechanical properties in the progression of cancer disease and inflammation. Rep Prog Phys. 77:0766022014. View Article : Google Scholar : PubMed/NCBI | |
Balkwill F: TNF-alpha in promotion and progression of cancer. Cancer Metastasis Rev. 25:409–416. 2006. View Article : Google Scholar : PubMed/NCBI | |
Orange ST, Leslie J, Ross M, Mann DA and Wackerhage H: The exercise IL-6 enigma in cancer. Trends Endocrinol Metab. 34:749–763. 2023. View Article : Google Scholar : PubMed/NCBI | |
Hart PC, Rajab IM, Alebraheem M and Potempa LA: C-reactive protein and cancer-diagnostic and therapeutic insights. Front Immunol. 11:5958352020. View Article : Google Scholar : PubMed/NCBI | |
Carnevale S, Ghasemi S, Rigatelli A and Jaillon S: The complexity of neutrophils in health and disease: Focus on cancer. Semin Immunol. 48:1014092020. View Article : Google Scholar : PubMed/NCBI | |
Zahorec R: Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy. 122:474–488. 2021.PubMed/NCBI | |
Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, Leibowitz-Amit R, Sonpavde G, Knox JJ, Tran B, et al: Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: A systematic review and meta-analysis. J Natl Cancer Inst. 106:dju1242014. View Article : Google Scholar : PubMed/NCBI | |
Shaul ME and Fridlender ZG: Tumour-associated neutrophils in patients with cancer. Nat Rev Clin Oncol. 16:601–620. 2019. View Article : Google Scholar : PubMed/NCBI | |
Masucci MT, Minopoli M and Carriero MV: Tumor associated neutrophils. Their role in tumorigenesis, metastasis, prognosis and therapy. Front Oncol. 9:11462019. View Article : Google Scholar : PubMed/NCBI | |
Wang B, Gu W, Wan F, Shi G and Ye D: Prognostic significance of the dynamic changes of systemic inflammatory response in metastatic renal cell carcinoma. Int Braz J Urol. 45:89–99. 2019. View Article : Google Scholar : PubMed/NCBI | |
Hu K, Lou L, Ye J and Zhang S: Prognostic role of the neutrophil-lymphocyte ratio in renal cell carcinoma: A meta-analysis. BMJ Open. 5:e0064042015. View Article : Google Scholar : PubMed/NCBI | |
Chandrasekaran D, Sundaram S, Maheshkumar K, Kathiresan N and Padmavathi R: Preoperative neutrophil-lymphocyte ratio/platelet-lymphocyte ratio: A potential and economical marker for renal cell carcinoma. J Cancer Res Ther. 18:1635–1639. 2022. View Article : Google Scholar : PubMed/NCBI | |
Ohno Y, Nakashima J, Ohori M, Gondo T, Hatano T and Tachibana M: Followup of neutrophil-to-lymphocyte ratio and recurrence of clear cell renal cell carcinoma. J Urol. 187:411–417. 2012. View Article : Google Scholar : PubMed/NCBI | |
Ito K, Masunaga A, Tanaka N, Mizuno R, Shirotake S, Yasumizu Y, Ito Y, Miyazaki Y, Hagiwara M, Kanao K, et al: Impact of inflammatory marker levels one month after the first-line targeted therapy initiation on progression-free survival prediction in patients with metastatic clear cell renal cell carcinoma. Jpn J Clin Oncol. 49:69–76. 2019. View Article : Google Scholar : PubMed/NCBI | |
Chen X, Meng F and Jiang R: Neutrophil-to-lymphocyte ratio as a prognostic biomarker for patients with metastatic renal cell carcinoma treated with immune checkpoint inhibitors: A systematic review and meta-analysis. Front Oncol. 11:7469762021. View Article : Google Scholar : PubMed/NCBI |