The prognostic significance of NLR in non-metastatic renal cell carcinoma undergoing nephrectomy, A meta-analysis

Abstract INTRODUCTION Neutrophil to Lymphocyte ratio (NLR) has been reported to correlate with poor survivals in many tumors. However, the association between preoperative NLR elevation and survival outcome in non-metastatic renal cell carcinoma (RCC) underdoing nephrectomy remains controversial. The aim of this meta-analysis was to investigate the prognostic significance of elevated NLR in non-metastatic RCC. EVIDENCE ACUISITION We systematically searched PubMed, EmBase, and the Cochrane Library databases in may 2018. Cancer specific survival (CSS), disease-free survival (DFS) and overall survival (OS) were pooled by hazard ratio (HR) with corresponding 95% confidence interval. EVIDENCE SYNTHESIS A total of 3,175 patients from 8 studies were analyzed. The results demonstrated that elevated pretreatment NLR was significantly related to poor CSS (HR 1.91, 95% CI=1.53-2.40), DFS (HR 1.38, 95% CI=1.09-1.74), and OS (HR 1.84, 95% CI=1.58-2.14) in patients with non-metastatic RCC. CONCLUSION Elevated NLR indicates a poor long-term survival (CSS, DFS and OS) in non-metastatic RCC. Patients with elevated NLR are more likely to have poor prognosis than those with lower NLR.