Investig Clin Urol.  2020 Sep;61(5):475-481. 10.4111/icu.20200002.

The platelet-to-lymphocyte ratio as a significant prognostic factor to predict survival outcomes in patients with synchronous metastatic renal cell carcinoma

  • 1Department of Urology, Seoul National University Hospital, Seoul, Korea
  • 2Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 3Department of Urology, Chonnam National University Medical School, Gwangju,Korea
  • 4Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan,Korea
  • 5Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,Korea
  • 6Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
  • 7Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 8Department of Urology, National Cancer Center, Goyang, Korea


The clinical impact of the platelet-to-lymphocyte ratio (PLR) on the prognosis of patients with metastatic renal cell carcinoma (mRCC) remains controversial. We investigated the associations between elevation of the PLR and disease prognosis in patients with synchronous mRCC.
Materials and Methods
The data of 1,505 patients with synchronous mRCC were retrospectively analyzed. The entire cohort was stratified into two subgroups according to PLR. Kaplan–Meier and Cox proportional analyses were performed to investigate the possible associations between the PLR and disease prognosis.
There were 921 patients with a high PLR and 584 patients with a low PLR by use of the cutoff of 146. The patients with a high PLR had worse clinical characteristics in terms of advanced clinical stage (p<0.001) and rate of lymph node invasion (p=0.036). The Kaplan–Meier analysis showed that patients with a high PLR had significantly shorter overall survival (OS) (p<0.001) and cancer-specific survival (CSS) (p<0.001). The multivariate Cox analysis revealed that the PLR was an independent predictor for shorter OS (hazard ratio [HR], 1.345; 95% confidence interval [CI], 1.183–1.530; p<0.001) and CSS (HR, 1.318; 95% CI, 1.156–1.502;p<0.001). In the subgroup analyses, the PLR showed a significant association with survival outcomes in the subgroup with clear cell type (all p<0.05) but not in the subgroup with the non–clear cell type.
The PLR was an independent prognostic factor for survival outcomes in patients with mRCC. However, the association was statistically significant only in patients with clear cell type mRCC.


Biomarkers; Blood platelets; Kidney neoplasms; Lymphocytes; Lymphocytes
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