MP22-10 COMPARATIVE ANALYSIS OF PREOPERATIVE INFLAMMATORY MARKERS FOR ONCOLOGIC AND RENAL FUNCTIONAL OUTCOMES AFTER SURGICAL TREATMENT OF RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2017MP22-10 COMPARATIVE ANALYSIS OF PREOPERATIVE INFLAMMATORY MARKERS FOR ONCOLOGIC AND RENAL FUNCTIONAL OUTCOMES AFTER SURGICAL TREATMENT OF RENAL CELL CARCINOMA Charles Field, Zachary Hamilton, Aaron Bloch, Katherine Fero, Daniel Han, Richmond Owusu, James Proudfoot, and Ithaar Derweesh Charles FieldCharles Field More articles by this author , Zachary HamiltonZachary Hamilton More articles by this author , Aaron BlochAaron Bloch More articles by this author , Katherine FeroKatherine Fero More articles by this author , Daniel HanDaniel Han More articles by this author , Richmond OwusuRichmond Owusu More articles by this author , James ProudfootJames Proudfoot More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.664AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 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. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e260 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Charles Field More articles by this author Zachary Hamilton More articles by this author Aaron Bloch More articles by this author Katherine Fero More articles by this author Daniel Han More articles by this author Richmond Owusu More articles by this author James Proudfoot More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...