Serum C-NLR score, a new inflammatory marker, predicts tumor histopathology and oncological outcomes of localized clear cell renal carcinoma after nephrectomy: A single center retrospective analysis: C-NLR score and clear cell renal carcinoma

Aykut Colakerol; Mustafa Zafer Temiz; Yigit Can Filtekin; Sergen Sahin; Ramazan Omer Yazar; Sule Ozsoy; Engin  Kandirali; Atilla Semercioz; Ahmet Yaser Muslumanoglu

doi:10.28982/josam.7663

Authors

Aykut Colakerol Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0002-5076-5306
Mustafa Zafer Temiz Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0002-5736-5495
Yigit Can Filtekin Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0002-8788-5598
Sergen Sahin Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0003-2951-5991
Ramazan Omer Yazar Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0002-5343-5345
Sule Ozsoy Department of Pathology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0002-6310-1947
Engin Kandirali Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0003-0580-2144
Atilla Semercioz Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0001-8688-4772
Ahmet Yaser Muslumanoglu Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey https://orcid.org/0000-0002-8691-0886

DOI:

https://doi.org/10.28982/josam.7663

Keywords:

clear cell renal cell carcinoma, c-reactive protein, neutrophils, lymphocytes, survival analysis

Abstract

Background/Aim: Several blood and serum-based parameters have been described as prognostic markers of clear cell renal cell carcinoma (ccRCC). But most of these markers have inconsistent results and are not used in routine clinical practice. Therefore, novel potential predictor biomarkers are needed for the management of ccRCC patients in clinical practice. Here, we investigate the predictive value of a novel marker, serum C-NLR score, for pathological characteristics and oncological outcomes of ccRCC.

Methods: A total of 162 RCC patients who underwent radical or partial nephrectomy between January 2015 and January 2021 were evaluated in a retrospective cohort study setting. The serum C-NLR score was compared according to the tumor histopathology-associated parameters. The predictive role of those parameters and C-NLR score on the oncological outcomes of ccRCC was also investigated.

Results: The median serum C-NLR scores exhibited statistically significant increases in ccRCC patients with pathological necrosis, lymphovascular invasion, and variant differentiation. Among histopathological characteristics, only tumor necrosis and variant differentiation were associated with overall survival (OS) and tumor grade with metastasis-free survival (MFS) (no metastasis detected in grade 1–2 tumors) in Kaplan Meier analyses. Serum C-NLR score was also associated with OS but not MFS. In the univariate analyses, tumor necrosis, variant differentiation, and C-NLR score were associated with OS of localized RCC patients who underwent nephrectomy (HR: 0.29; 95% CI: 0.08–1.01; P=0.04, HR: 6.01; 95% CI: 1.66–21.82; P=0.006 and, HR: 1.21; 95% CI: 0.20–5.16; P=0.04). However, in the multivariate analysis, only variant differentiation and C-NLR score were associated with OS (HR: 1.43; 95% CI: 0.82–2.98; P=0.03 and HR: 1.21; 95% CI: 0.20–5.16; P=0.04). Tumor grade was directly associated with MFS because grade 1–2 tumors did not exhibit any metastasis.

Conclusion: Serum C-NLR score was higher in worse histopathological entities. Moreover, it predicts the OS for patients with ccRCC as an independent factor.

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