Login to Access Video or Poster Abstract: MP22-10
Sources of Funding: Stephen Weissman Kidney Cancer Research Fund. NIH grants UL1TR000100 and UL1TR001442.

Introduction

Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), De Ritis Ratio (AST/ALT), and C-reactive protein (CRP) are inflammatory markers with varying predictive ability of treatment outcomes in malignancy. We sought to evaluate the utility of these markers for oncologic and renal functional outcomes in patients who have undergone partial or radical nephrectomy for suspected renal cell carcinoma (RCC).

Methods

Single center, retrospective analysis 945 patients from 2003-2016 (494 PN, 451 RN, mean follow up 41.9 months). Primary outcome was de novo estimated Glomerular Filtration Rate (GFR<45 ml/min/1.73m2) at last follow up Secondary outcomes included overall survival (OS) and recurrence. Kaplan Meier (KM) and multivariate analysis (MVA) were utilized to evaluate association of preoperative markers (NLR, PLR, De Ritis Ratio, CRP) with outcomes. Predetermined cutoffs of NLR >3, PLR >185, De Ritis >1.5, and CRP >3 were used.

Results

MVA for GFR <45 noted De Ritis ratio (HR 1.99, p<0.01), hypertension (HR 1.69, p=0.02), and coronary artery disease (HR 1.81, p<0.01). Cox model results using predetermined cutoffs for GFR<45 was significant for NLR (HR 2.09, p<0.01), PLR (1.88, p=0.01), and De Ritis (2.24, p<0.01). MVA for worsened OS noted CRP (HR 1.26, p<0.01) and RN (HR 6.99, p<0.01). Cox model results using predetermined cutoffs for OS was significant for NLR (HR 2.24, p=0.049), De Ritis (HR 3.92, p<0.01), and CRP (HR 4.0, p<0.01). Preoperative markers were not associated with recurrence on MVA.

Conclusions

De Ritis ratio and comorbid conditions are independent predictors of GFR <45, while CRP and RN are predictive of worsened OS. Using predetermined cutoffs of NLR >3, PLR >185, De Ritis >1.5, and CRP >3 shows significant associations for NLR, PLR, and De Ritis for GFR <45 and NLR, De Ritis, and CRP for worsened OS. Our data suggest a focus on these markers for development of prognostic models. Further investigation is requisite to validate our findings.

Funding

Stephen Weissman Kidney Cancer Research Fund. NIH grants UL1TR000100 and UL1TR001442.