Background: We evaluated the prognostic value of preoperative blood glucose to lymphocyte ratio (GLR) in renal cell carcinoma (RCC) patients who underwent laparoscopic nephrectomy through a multi-institutional clinical study.
Methods: A total of 420 patients with RCC from three medical centers from 2014 to 2019 were included in this study. The effect of GLR on overall survival (OS) and cancer-specific survival (CSS) in RCC patients was assessed by Kaplan-Meier survival curves, univariate and multivariate Cox regression analysis. Moreover, a 1:1 propensity score matching (PSM) analysis of different GLR groups was utilized to further confirm the prognostic ability of GLR.
Results: The optimal cut-off value for GLR was 6.8. Patients were divided into high GLR and low GLR groups according to the optimal cut-off value. GLR was significant association with diabetes, cardiovascular disease and AJCC stage. High GLR predicted adverse OS ( P = 0.002) and CSS ( P < 0.01) in RCC patients. Multivariate Cox regression analysis revealed that high GLR was an independent prognostic factor for OS [hazard ratio (HR): 2.389, 95% confidence interval (CI), 1.136-5.027, P = 0.008] and CSS (HR: 3.474, 95% CI, 1.555-7.761, P = 0.002). After PSM analysis of the patients in the high GLR and low GLR groups, high GLR still predicted poor OS ( P = 0.021) and CSS ( P = 0.037).
Conclusions: High GLR is associated with adverse prognosis in RCC patients, and GLR can serve as an independent prognostic marker for OS and CSS in RCC patients receiving laparoscopic nephrectomy.
Keywords: cancer-specific survival; glucose to lymphocyte ratio; overall survival; prognosis; renal cell carcinoma.
© 2022 Ni, Li, Song, Zhang, Wang, Zhang, Zhang, Yang, Xie, Wang, Peng and Mao.