Markers of systemic inflammation predict survival in patients with advanced renal cell cancer

P. Fox, M. Hudson, C. Brown, S. Lord, V. Gebski, P. De Souza, C. K. Lee*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

130 Citations (Scopus)


Background:The host inflammatory response has a vital role in carcinogenesis and tumour progression. We examined the prognostic value of inflammatory markers (albumin, white-cell count and its components, and platelets) in pre-treated patients with advanced renal cell carcinoma (RCC).Methods:Using data from a randomised trial, multivariable proportional hazards models were generated to examine the impact of inflammatory markers and established prognostic factors (performance status, calcium, and haemoglobin) on overall survival (OS). We evaluated a new prognostic classification incorporating additional information from inflammatory markers.Results:Of the 416 patients, 362 were included in the analysis. Elevated neutrophil counts, elevated platelet counts, and a high neutrophil-lymphocyte ratio were significant independent predictors for shorter OS in a model with established prognostic factors. The addition of inflammatory markers improves the discriminatory value of the prognostic classification as compared with established factors alone (C-statistic 0.673 vs 0.654, P=0.002 for the difference), with 25.8% (P=0.004) of patients more appropriately classified using the new classification.Conclusion:Markers of systemic inflammation contribute significantly to prognostic classification in addition to established factors for pre-treated patients with advanced RCC. Upon validation of these data in independent studies, stratification of patients using these markers in future clinical trials is recommended.

Original languageEnglish
Pages (from-to)147-153
Number of pages7
JournalBritish Journal of Cancer
Issue number1
Publication statusPublished - 9 Jul 2013
Externally publishedYes


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