Which Preoperative Inflammation Markers are More Valuable Prognostic Markers in Renal Cell Cancer Patients who Have Undergone Nephrectomy?
Tarik Demir1, Mehmet Besiroglu21Departments of Medical Oncology, University of Health Sciences, Hamidiye Faculty of Medicine, Haydarpaşa Numune Health Application and Research Center, Istanbul, Turkey, 2Departments of Medical Oncology, Bezmialem Vakif University, Faculty of Medicine Hospital, Istanbul, Turkey
Objectives: This retrospective study evaluated the prognostic significance of inflammation markers (IMs) in patients with renal cell cancer (RCC) who had undergone nephrectomy. Methods: A total of 118 patients—39 (33.1%) were female, and 79 (66.9%) were male—were included in the study. All medical records were reviewed retrospectively. The cut-off values for the IMs (c-reactive protein (CRP), CRP/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammatory index (neutrophils × platelets)/lymphocytes) (SIII)) were defined by receiver operating characteristic (ROC) analysis. Overall survival (OS) and disease-free survival (DFS) were plotted using the Kaplan–Meier method and compared using the log-rank test. Cox regression analysis was performed for univariate and multivariate analyses, and hazard ratios (HRs) with 95% confidence intervals (CIs) were used to quantify the indices for estimating survival. Results: An optimal CAR cut-off value of 8 was defined according to the ROC analysis. The area under the curve for CAR (0.755) for OS and DFS was greater than that for CRP, NLR, PLR, and SIII. Multivariate analysis demonstrated that CAR is an independent prognostic factor for OS (p<0.001) in patients with RCC who have undergone nephrectomy. Conclusion: The findings of the present study suggest that preoperative CAR might be an independent prognostic marker for patients with RCC who have undergone nephrectomy and might have value compared with other established inflammation-based prognostic scores. The prognostic value of this novel inflammation-based prognostic score needs to be verified in patients with other types of cancer. Keywords: C-Reactive protein to albumin ratio, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, prognostic score, renal cell cancer
Cite This Article
Demir T, Besiroglu M. Which Preoperative Inflammation Markers are More Valuable Prognostic Markers in Renal Cell Cancer Patients who Have Undergone Nephrectomy?. EJMI. 2020; 4(2): 209-216
Corresponding Author: Tarik Demir