***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 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 r and omised 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 OBJECTIVES : To assess the impact of baseline nutritional status on treatment response and survival in nonmetastatic patients with a locally advanced esophageal cancer ( LAEC ) treated with definitive chemoradiotherapy ( CRT ) .  METHODS : One hundred five patients with LAEC treated by definitive CRT were retrospectively included . The CRT regimen was based on an external radiotherapy ( RT ) delivered concomitantly to a cisplatin-based chemotherapy ( CT ) . Patients were considered to have a complete response ( CR ) to CRT when no residual tumor was detected on CT scan and esophagoscopy performed 2 months after the end of CRT . Multivariate analysis of predictive factors of response to CRT and survival were performed using a logistic regression and a Cox model , respectively . RESULTS : Mean value of baseline nutritional parameters was significantly different between nonresponder ( N = 42 ) and responder ( N = 63 ) patients to CRT ( weight loss 10 % vs 5.8 % , P = 0.0047 ; serum albumin level 35 g/L vs 38.7 g/L , P = 0.0004 ; BMI 22.8 kg/m2 vs 25.2 kg/m2 , P = 0.01 ) . In multivariate analysis , serum albumin level > 35 g/L was the only independent predictive factor of CR to CRT ( P = 0.009 ) . Independent prognostic factors of survival were BMI > 18 kg/m2 ( P = 0.003 ) , dysphagia Atkinson score < 2 ( P = 0.008 ) , dose of RT > 50 Grays ( Gy ) ( P < 0.0001 ) and CR to CRT ( P < 0.0001 ) . CONCLUSIONS : Survival was influenced by baseline nutritional status as well as dysphagia , dose of RT , and CR to CRT . Despite the retrospective design of the study , our results may provide the concept basis for performing a prospect i ve nutritional intervention study in patients treated by definitive CRT for an esophageal cancer BACKGROUND This study concerns clinical characteristics and survival of renal cell carcinoma ( RCC ) patients in University Malaya Medical Centre ( UMMC ) , as well as the prognostic significance of presenting symptoms . MATERIAL S AND METHODS The clinical characteristics , presenting symptoms and survival of RCC patients ( n=151 ) treated at UMMC from 2003 - 2012 were analysed . Symptoms evaluated were macrohaematuria , flank pain , palpable abdominal mass , fever , lethargy , loss of weight , anaemia , elevated ALP , hypoalbuminemia and thrombocytosis .  Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms . Kaplan Meier and log rank tests were employed for survival analysis . RESULTS The 2002 TNM staging was a prognostic factor ( p<0.001 ) but Fuhrman grading was not significantly correlated with survival ( p=0.088 ) . At presentation , 76.8 % of the patients were symptomatic . Generally , symptomatic tumours had a worse survival prognosis compared to asymptomatic cases ( p=0.009 ; HR 4.74 ) . All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis . On multivariate analysis adjusted for stage , only clinical ly palpable abdominal mass remained statistically significant ( p=0.027 ) . The mean tumour size of palpable abdominal masses , 9.5±4.3 cm , was larger than non palpable masses , 5.3±2.7 cm ( p<0.001 ) . CONCLUSIONS This is the first report which includes survival information of RCC patients from Malaysia . Here the TNM stage and a palpable abdominal mass were independent predictors for survival . Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients 
    Output:
    
In conclusion , a decreased pretreatment serum albumin level implies a poor prognosis for RCC patients , and can be monitored for risk stratification and individualized treatment in RCC patients