The Role of Hematological Parameters in Predicting Fuhrman Grade and Tumor Stage in Renal Cell Carcinoma Patients Undergoing Nephrectomy

Abstract

Background and objective: We investigated the ability of preoperative serum values of red blood cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and plateletcrit (PCT) to predict Fuhrman grades (FG) and tumor stages of renal cell carcinoma in patients who underwent radical nephrectomy. Materials and methods: Records of 283 patients that underwent radical or partial nephrectomy of renal masses at our clinic between January 2010 and April 2018, whose pathology results indicated renal cell carcinoma (RCC), and who had their FG and T1–4 N0M0 identified were retrospectively evaluated. The patients were divided into two groups based on their FG as low (I–II) and high (III–IV) and their T stages were similarly grouped as limited to kidney (pT1–pT2) and not limited to kidney (pT3–pT4). Results: Mean RDW, NLR, PCT cut-off values of the patients for FG and T stage were 15.65%, 3.54, 0.28% and 14.35%, 2.69, 0.28%, respectively. The RDW and NLR were determined to be statistically significant predictors of a pathologically high FG, whereas the PCT value was not a statistically significant predictor of high FG (p = 0.003, p = 0.006, p = 0.075, respectively). The relationship of RDW, NLR and PCT values with a limited to the kidney pathological T stage revealed statistically significant correlations for all three values. Conclusions: We determined that only RDW and NLR were markers predicting FG, while PCT had no prognostic value. On the other hand, all three of these values were associated with a limited to the kidney pathological T stage in patients who underwent nephrectomy due to renal masses and whose pathologies suggested RCC.

Neutrophil-Lymphocyte Ratio is Valuable in Predicting the Pathology Result in the Patients with Renal Mass > 4 cm Prior to the Partial Nephrectomy

“…In the study performed by Widz et al, high NLR (≥2,69) significantly correlated with worse survival outcome and higher tumor stage (26). Kısa et al reported that higher NLR (>2,6) was associated with increased risk of pT 3-4 tumors (27). In our study, a cut-off value of 2,31 was associated with increased risk of tumors > 4 cm and it was compatible with the literature.…”

Pre-operative Plateletcrit vs. Neutrophil to Lymphocyte Ratio in Predicting Biological Tumor Behavior in Patients with T1-4, N0, M0 Renal Cell Carcinoma: A Retrospective Analysis

“…In ROC curve analysis, a larger AUC indicates a better diagnostic efficiency. Kisa E et al found that PCT had a significant association with a high stage of RCC, whereas it was not associated with a high grade of tumor (23). Concordantly, when we used ROC curves to analyze the performance of PCT and NLR for distinguishing higher stage and grade of tumor, we found that high PCT was significantly associated with high stage and grade.…”

Clinical Impact of Preoperative Neutrophil-Lymphocyte Ratio in Renal Cell Carcinoma in Sardjito Hospital

“…We also conclude that there is not a significant linear correlation between NLR levels with Fuhrman grade and recurrence rate in our study population. These findings are different from those of the previous study, mostly suggesting that the elevation of NLR will also increase the Fuhrman grade and vice versa [28,29]. For recurrence rate, previous studies found that high NLR was correlated with a high tendency of recurrence rate [30,31].…”