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Master Thesis

Impact pronostique des rapports neutrophiles/lymphocytes pré-opératoire et post-opératoire dans le cancer du rein non métastatique (UroCCR n°61)

Abstract : Introduction: the neutrophil to lymphocyte ratio (NLR) is an established marker of systemic inflammation and its value as a biomarker has been reported in other cancers. The aim of this study was to assess the prognostic value of pre- and post-operative NLR in non-metastatic kidney cancer. Its ease of obtaining could improve follow-up recommendations. Material and Methods: single-center retrospective study from cases prospectively included after written consent in the French UroCCR database (CNIL DR 2013-206; NCT03293563). We included patients operated on for stage pT1-4N0M0 kidney cancer between May 2000 and January 2019. The associations between clinical, biological, pathological variables and pre- and post-operative NLRs were assessed in univariate and multivariate analyzes. An analysis of recurrence-free survival according to Kaplan Meier as a function of the pre- and post-operative NLR was performed and then stratified by the SSIGN and UISS score. Results: a total of 789 patients were included. The mean follow-up on the cohort was 57.5 ± 35 months and 137 patients presented with local or distant recurrence. The mean preoperative NLR was 4.2 ± 4 in the recurrence group vs. 2.5 ± 1.7 (p <0.001). The mean postoperative NLR was 4 ± 2.9 vs 2.7 ± 2.5 (p <0.001). The mean NLR at recurrence was 4.9 ± 3.7. In multivariate analysis, the preoperative NLR> 2.7 was an independent risk factor for recurrence (OR 2.9 [1.1-7.8] p = 0.034). We assessed recurrence-free survival based on NLR and it was significantly unfavorable when NLR was> 2.7 preoperatively and postoperatively (p <0.001). Conclusion: the preoperative NLR> 2.7 was significantly independently associated with the risk of disease recurrence. Moreover, the NLR was significantly increased on recurrence. It could therefore be a biomarker, economical and easy to use.
Keywords : UISS
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Submitted on : Monday, January 18, 2021 - 4:27:59 PM
Last modification on : Tuesday, February 2, 2021 - 3:12:13 AM
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Clément Allenet. Impact pronostique des rapports neutrophiles/lymphocytes pré-opératoire et post-opératoire dans le cancer du rein non métastatique (UroCCR n°61). Sciences du Vivant [q-bio]. 2020. ⟨dumas-03113923⟩

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