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document
Markers of systemic inflammation predict survival in patients with advanced renal cell cancer . 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 .
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Intervention_Other
inflammatory markers
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Intervention_Physical
platelets
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Intervention_Physical
generated
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Intervention_Physical
prognostic classification
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Outcome_Physical
systemic inflammation
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Outcome_Physical
prognostic value of inflammatory markers ( albumin , white-cell count and its components , and platelets )
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Outcome_Physical
impact of inflammatory markers
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Outcome_Physical
prognostic factors
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Outcome_Mortality
overall survival
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Outcome_Physical
Elevated neutrophil counts
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Outcome_Physical
elevated platelet counts
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Outcome_Physical
high neutrophil-lymphocyte ratio
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Participant_Condition
advanced renal cell cancer
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Participant_Condition
advanced renal cell carcinoma
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Participant_Sample-size
416 patients
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Participant_Sample-size
362