Abstract
Background This study aimed to determine the prognostic value of preoperative blood parameters in renal cell carcinoma (RCC) and tumour thrombus (TT) patients that were surgically treated.MethodWe retrospectively analysed clinicopathological data and blood parameters of 146 RCC and TT patients that were surgically treated. Univariate or multivariate Cox regression analyses were performed to determine the risk factors associated with progression-free survival (PFS) and overall survival (OS). Kaplan-Meier analysis and logistic regression were performed to study the risk factors. Receiver operating characteristic curves were applied to test improvements in the predictive accuracy of the established prognosis score.ResultsOn univariate and multivariate analysis, anaemia (HR 2.873, P = 0.008) and lymph node metastasis (HR 4.811, P = 0.015) were independent prognostic factors linked to OS. Besides, thrombocytosis (HR 2.324, P = 0.011), histologic subtype (HR 2.835, P = 0.004), nuclear grade (HR 2.069, P = 0.033), and lymph node metastasis (HR 5.739, P = 0.001) were independent prognostic factors associated with PFS. Kaplan–Meier curves revealed that patients with anaemia exhibited worse OS than those without it (P = 0.0033). Likewise, patients with thrombocytosis showed worse PFS than those without it (P < 0.0001). Adding the anaemia and thrombocytosis to the SSIGN score improved its predictive accuracy related to OS and PFS. Preoperative anaemia was linked to more symptom at presentation (OR 3.348, P = 0.006), longer surgical time (OR 1.005, P = 0.001), more blood loss (OR 1.000, P = 0.018), more transfusion (OR 2.734, P = 0.004), higher thrombus level (OR 4.750, P = 0.004) and higher nuclear grade (OR 3.449, P = 0.001) while thrombocytosis was associated with more symptom at presentation (OR 7.784, P = 0.007).ConclusionsPreoperative anaemia and thrombocytosis were adverse prognostic factors in non-metastatic RCC patients with TT. Also, both preoperative anaemia and thrombocytosis can be clinically used for risk stratification of non-metastatic RCC and TT patients.
Highlights
This study aimed to determine the prognostic value of preoperative blood parameters in renal cell carcinoma (RCC) and tumour thrombus (TT) patients that were surgically treated
Thrombocytosis (HR 2.324, P = 0.011), histologic subtype (HR 2.835, P = 0.004), nuclear grade (HR 2.069, P = 0.033), and lymph node metastasis (HR 5.739, P = 0.001) were independent prognostic factors associated with progression-free survival (PFS)
Preoperative anaemia was linked to more symptom at presentation, longer surgical time, more blood loss, more transfusion, higher thrombus level and higher nuclear grade while thrombocytosis was associated with more symptom at presentation
Summary
This study aimed to determine the prognostic value of preoperative blood parameters in renal cell carcinoma (RCC) and tumour thrombus (TT) patients that were surgically treated. The inflammation status has been well associated with genesis, progression, and metastasis of tumours [4]. Preoperative inflammation indicators such as neutrophils, lymphocytes, platelets, neutrophil-lymphocyte ratio (NLR), and the platelet lymphocyte ratio (PLR) have been reported for prognostic value in urologic malignancies such as prostate and bladder cancers [5, 6]. Other preoperative blood parameters such as haemoglobin, AST/ALT, albumin have been suggested to hold prognostic values predicting survival in RCC [10]. A novel prognostic system incorporating preoperative blood parameters has been designed to improve prognostic accuracy to predict metastatic RCC [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
