962 Prognostic Value of Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) for Small Renal Cell Carcinomas (RCC) After Image-Guided Cryoablation or Radio-Frequency Ablation (RFA)

Abstract

Abstract Aim This is the first study investigating the relationship between NLR or PLR and outcomes of percutaneous cryoablation or RFA for small RCCs with long-term outcomes. Method All patients undergoing cryoablation or RFA for small RCCs (<7cm) from 2003–2016 at a regional centre for RCC were included. Optimal cut-offs for NLR/PLR were determined using the ROC curve and AUC using the Youden method. Outcomes were compared using Cox or logistic regression. Results 203 patients (Cryoablation:103, RFA:100) were included. Median follow-up was 75 months and 98 months, respectively. Using the Youden method, high post-operative NLR values were associated with worsened local recurrence-free survival (LRFS) (NLR >5.38; HR: 5.13, p=0.037) and worsened Overall Survival (OS) (NLR >6.42; HR: 3.40, p<0.001) in all patients. High post-operative PLR values were associated with worsened OS in all patients (PLR >192; HR: 2.31, p=0.006) and RFA patients alone (n=100; PLR >260; HR: 8.27, p<0.001). Using continuous Cox regression model, greater changes in peri operative NLR were associated with worsened LRFS in cryoablation alone and all patients (Continous; HR: 1.09, p=0.028). Higher post-operative NLR was also associated with worsened LRFS in cryoablation patients alone (HR: 1.10, p=0.046). Post-operative NLR (HR:1.17, p=0.002), change in peri-operative NLR (HR:1.19, p=0.001), and change in peri-operative PLR (HR:1.20, p=0.009) were all associated with worsened CSS in all patients. Pre-operative PLR and NLR were not associated with complications and change in renal function. Conclusion NLR and PLR are valuable prognostic factors for this group of patients and should be used to guide subsequent follow-up and monitoring of recurrence.