Prognostic value of glucose to lymphocyte ratio for patients with renal cell carcinoma undergoing laparoscopic nephrectomy: A multi-institutional, propensity score matching cohort study.

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.

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.

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).

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.

Frontiers in surgery. 2022 Sep 29*** epublish ***

Jinliang Ni, Ziye Li, Wei Song, Houliang Zhang, Yidi Wang, Yifan Zhang, Haipeng Zhang, Guangcan Yang, Jun Xie, Keyi Wang, Bo Peng, Weipu Mao

Department of Urology, Shidong Hospital of Yangpu District, Shanghai, China., Shanghai Clinical College, Anhui Medical University, Shanghai, China., Department of Urology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China.