초록접수 현황
| 17F-047 | 구연 미채택시 포럼 발표 |
Prognostic Significance of Neutrophil-lymphocyte Ratio in Patients Undergoing Pulmonary Metastasectomy for Metastatic Renal Cell Carcinoma
Dong Woog Yoon¹, Hong Kwan Kim¹, Seong Il Seo², Sumin Shin¹, Jong Ho Cho¹, Yong Soo Choi¹, Jhingook Kim¹, Jae Ill Zo¹, Young Mog Shim¹
¹Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., ²Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : Since the role of pulmonary metastasectomy (PM) remains controversial in metastatic renal cell carcinoma (RCC), understanding prognostic factors could help select optimal candidates for PM. Although neutrophil-lymphocyte ratio (NLR) is considered as a critical prognosticator in RCC, its prognostic significance in PM for metastatic RCC has never been studied. We investigated the treatment outcomes and prognostic factors, including NLR, after PM for metastatic RCC.
Methods : Between 1997 and 2014, 93 patients underwent PM for metastatic RCC at our institution. A retrospective review was performed and multivariate Cox regression analysis was used to determine factors associated with survival outcomes.
Results : The mean age was 56 years (78 men, 84%). Most patients underwent PM for metachronous lesions (n=70, 75%) with a mean disease-free interval (DFI) of 37 months. Forty-seven patients (51%) had solitary lesion. Wedge resection was most commonly performed (n=72, 77%). Targeted therapy was administered in 51 patients (55%) and 19 (20%) underwent repeated PM. With a median follow-up of 47 months, 5-year overall and 2-year disease-free survival rates were 62% and 34%, respectively. Higher NLR (hazard ratio (HR)=2.4, p=0.048), multiplicity (HR=2.85, p=0.003), and repeated PM (HR=0.26, p=0.017) were independent prognostic factors. Among 51 patients on targeted therapy, higher NLR (HR=6.55, p=0.001), repeated PM (HR=0.10, p=0.033), and longer DFI (HR=0.27, p=0.024) were independent prognostic factors.
Conclusion : PM for metastatic RCC seems to be beneficial in selected patients, especially with lower NLR, single lesion, and longer DFI. NLR might be helpful when selecting the optimal candidates for PM regardless of the use of targeted therapy.
Methods : Between 1997 and 2014, 93 patients underwent PM for metastatic RCC at our institution. A retrospective review was performed and multivariate Cox regression analysis was used to determine factors associated with survival outcomes.
Results : The mean age was 56 years (78 men, 84%). Most patients underwent PM for metachronous lesions (n=70, 75%) with a mean disease-free interval (DFI) of 37 months. Forty-seven patients (51%) had solitary lesion. Wedge resection was most commonly performed (n=72, 77%). Targeted therapy was administered in 51 patients (55%) and 19 (20%) underwent repeated PM. With a median follow-up of 47 months, 5-year overall and 2-year disease-free survival rates were 62% and 34%, respectively. Higher NLR (hazard ratio (HR)=2.4, p=0.048), multiplicity (HR=2.85, p=0.003), and repeated PM (HR=0.26, p=0.017) were independent prognostic factors. Among 51 patients on targeted therapy, higher NLR (HR=6.55, p=0.001), repeated PM (HR=0.10, p=0.033), and longer DFI (HR=0.27, p=0.024) were independent prognostic factors.
Conclusion : PM for metastatic RCC seems to be beneficial in selected patients, especially with lower NLR, single lesion, and longer DFI. NLR might be helpful when selecting the optimal candidates for PM regardless of the use of targeted therapy.
책임저자: Hong Kwan Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Dong Woog Yoon, E-mail : yoondw86@naver.com