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Validation and comparison of prognostic value of different preoperative systemic inflammation indices in non-metastatic renal cell carcinoma

  • Urology - Original Paper
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Abstract

Background

Several preoperative systemic inflammation indices have been proven to be correlated with the prognosis of patients diagnosed with non-metastatic renal cell carcinoma (RCC). However, these indices are currently not included in the main prognostic models, and few studies have compared the prognostic efficacy of different preoperative systemic inflammation indices.

Patients and methods

This retrospective study reviewed patients diagnosed with non-metastatic RCC who underwent nephrectomy at West China Hospital of Sichuan University from 2011 to 2013. Different preoperative systemic inflammation indices (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], monocyte-to-lymphocyte ratio [MLR], systemic immune-inflammation index [SII], and systemic inflammation response index [SIRI]) were calculated. Logistic regression was used to explore the relationship between systemic inflammation indices and clinical characteristics, and Cox regression was used to identify independent prognostic factors of overall survival (OS). The concordance index (c-index) was also calculated.

Results

A total of 820 patients were included in the study, with a median follow-up of 78 months. Higher levels of NLR (> 3.04), PLR (> 147), MLR (> 0.32), SII (> 700), and SIRI (> 1.27) were found to be associated with more advanced tumor stage, higher Furman grade, and larger tumor size. In multivariate Cox regression, NLR, PLR, MLR, SII, and SIRI were identified as independent prognostic factors, and SII had the highest and most significant hazard ratio and the largest c-index.

Conclusion

In conclusion, various systemic inflammation indices were found to be associated with poorer OS. Among them, SII exhibited the highest predictive efficacy, suggesting its potential inclusion as a component in future prognostic models.

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Availability of data and materials

Data for this study will be provided by the corresponding author for reasonable reasons.

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Author notes

  1. Yaxiong Tang, Yanxiang Shao and Xu Hu contributed equally to this study.

Authors and Affiliations

  1. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China

    Yaxiong Tang, Yanxiang Shao, Xu Hu & **ang Li

  2. Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, 610072, China

    Shangqing Ren

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  1. Yaxiong Tang
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All listed authors contributed to data collection, collation, analysis, and writing of the manuscript and approved the submission of the manuscript.

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Correspondence to **ang Li.

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The authors declare no competing interests.

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The ethical standards set by the ethics committee of Sichuan University West China Hospital were followed during all human participant studies. This study was approved by the ethics committee of Sichuan University West China Hospital, and the requirement for informed consent was waived by the board.

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Tang, Y., Shao, Y., Hu, X. et al. Validation and comparison of prognostic value of different preoperative systemic inflammation indices in non-metastatic renal cell carcinoma. Int Urol Nephrol 55, 2799–2807 (2023). https://doi.org/10.1007/s11255-023-03724-9

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  • DOI: https://doi.org/10.1007/s11255-023-03724-9

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