The Four-Feature Prognostic Models for Cancer-Specific and Overall Survival after Surgery for Localized Clear Cell Renal Cancer: Is There a Place for Inflammatory Markers?

Abstract

We aimed at a determination of the relevance of comorbidities and selected inflammatory markers to the survival of patients with primary non-metastatic localized clear cell renal cancer (RCC). We retrospectively analyzed data from a single tertiary center on 294 patients who underwent a partial or radical nephrectomy in the years 2012–2018. The following parameters were incorporated in the risk score: tumor stage, grade, size, selected hematological markers (SIRI—systemic inflammatory response index; SII—systemic immune-inflammation index) and a comorbidities assessment tool (CCI—Charlson Comorbidity Index). For further analysis we compared our model with existing prognostic tools. In a multivariate analysis, tumor stage (p = 0.01), tumor grade (p = 0.03), tumor size (p = 0.006) and SII (p = 0.02) were significant predictors of CSS, while tumor grade (p = 0.02), CCI (p = 0.02), tumor size (p = 0.01) and SIRI (p = 0.03) were significant predictors of OS. We demonstrated that our model was characterized by higher accuracy in terms of OS prediction compared to the Leibovich and GRANT models and outperformed the GRANT model in terms of CSS prediction, while non-inferiority to the VENUSS model was revealed. Four different features were included in the predictive models for CSS (grade, size, stage and SII) and OS (grade, size, CCI and SIRI) and were characterized by adequate or even superior accuracy when compared with existing prognostic tools.

The Clinical Utility of Systemic Immune-Inflammation Index Supporting Charlson Comorbidity Index and CAPRA-S Score in Determining Survival after Radical Prostatectomy—A Single Centre Study

“…In recent years, complete blood count inflammatory markers have been sequentially introduced as predictors of survival in localized renal cell cancer [ 12 , 13 , 14 ] and bladder cancer [ 15 , 16 ], as well as in radio-recurrent [ 17 ] and castration-resistant prostate cancer [ 18 ]. The systemic immune-inflammation index (SII) is a novel, recently developed blood count-derived marker that has shown particularly promising predictive properties in the cohort with non-metastatic prostate cancer [ 19 ], which constitutes a population with excellent early survival.…”

Preoperative systemic immune‐inflammation index as a significant prognostic factor after TURBT in patients with non‐muscle‐invasive bladder cancer: A retrospective study based on propensity score matching analysis

“…The systemic immune‐inflammation index (SII) has been proposed as a potential SIR indicator that may be helpful for prognostic prediction in patients with various malignancies. 14 , 15 , 16 However, studies examining its value in NMIBC are still limited.…”

“…These markers offer a lot of potential for clinical use as they are rapid, precise, practical, and affordable. The systemic immune‐inflammation index (SII) has been proposed as a potential SIR indicator that may be helpful for prognostic prediction in patients with various malignancies 14–16 . However, studies examining its value in NMIBC are still limited.…”

Advances in the Treatment of Kidney and Upper Urinary Tract Cancers

“…This Special Issue aims to cover novel approaches in renal and urothelial cancers. We collected papers focused on novel approaches to urothelial cancers involving upper urinary tract and renal cancers that undertook original research focused on pre-clinical studies and biomarkers [ 9 , 10 , 11 , 12 ], prognostic models [ 13 , 14 , 15 ], the specific population of metastatic patients [ 16 ], and, finally, two narrative reviews [ 17 , 18 ].…”

“…In the paper by Zapala L. et al [ 13 ], the authors performed an analysis of the relevance of comorbidities and selected inflammatory markers on the survival of patients with primary non-metastatic localized cRCC. In a single-center retrospective cohort of patients post-renal surgery, they included the following parameters in the risk calculations, namely, tumor stage, grade, size, selected hematological markers (SIRI—systemic inflammatory response index; SII—systemic immune-inflammation index), and a comorbidities assessment tool (CCI—Charlson comorbidity index), and then further compared the new concept model with the existing prognostic tools.…”