Prognostic Value of Inflammatory and Nutritional Scores in Renal Cell Carcinoma After Nephrectomy

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Abstract

Micro-Abstract

Various biomarkers that reflect the nutrition and inflammation status have been associated with survival for renal cell carcinoma (RCC) patients. In the present study, we compared the prognostic significance of inflammatory and nutritional scores, including the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio, in patients with RCC undergoing nephrectomy and found PNI might be a better prognostic factor than are other factors for both overall survival and progression-free survival.

Introduction:

We compared the prognostic significance of inflammatory and nutritional scores, including the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio in patients with renal cell carcinoma (RCC) undergoing nephrectomy.

Patients and Methods:

We retrospectively analyzed the data from 1360 patients with RCC undergoing nephrectomy from 2001 to 2010. The PNI was calculated as the serum albumin level (g/L) + 5 × lymphocyte count (109/L). The receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values. The areas under the ROC curve (AUCs) were calculated to compare the predictive ability of the indexes. Univariate and multivariate analyses were used to identify the prognostic factors for overall survival (OS) and progression-free survival (PFS).

Results:

The median follow-up period after surgery was 67 months (range, 2-108 months). The PNI had the largest AUC for both OS and PFS. On univariate analysis, each index was associated with OS and PFS. On multivariate analysis, PNI, rather than other inflammatory and nutritional scores, remained as a risk factor for OS (hazard ratio [HR], 1.645; 95% confidence interval [CI], 1.153-2.348; 2P = .006) and PFS (HR, 1.705; 95% CI, 1.266-2.296; 2P < .001).

Conclusion:

The preoperative PNI might be a good prognostic factor for both OS and PFS in RCC patients undergoing nephrectomy.

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