The pan-immune-inflammation value: A novel independent predictive factor for overall survival in ≥pT2a nonmetastatic renal cell carcinoma.

Purpose: Aimed to evaluate the prognostic value of Pan-Immune-Inflammation Value (PIV) for overall survival (OS) in the localized RCC. We also tested the feasibility of incorporating the PIV into UCLA Integrated Staging System (UISS).

Materials and methods: Retrospectively evaluated 197 consecutive ≥pT2a radical nephrectomy patients. PIV and other blood based inflammatory markers were calculated. The optimal cut-offs of inflammatory markers were determined. The C-index was calculated. Cox regression analyses were done.

Results: Median age and follow-up time were 59 yrs. and 49 mo., respectively. Two, 5 and 10 years OS was 81.4%, 69.4% and 45.6%. Age, BMI, anemia, lymph node positivity, UISS and all inflammatory markers were found to be significant predictive factors. However, PIV had the highest hazard ratio [HR: 2.39 (1.38-4.14)] and also had highest C-index contribution (+0.24%) in multivariable analyses. Furthermore, both UISS and PIV remained independent predictive factors (P = 0.027 and P = 0.002, respectively). Additionally, pre- and postoperative low PIV provided about half reduction in the risk of death [HR: 0.44 (0.24-0.81), P = 0.008].

Conclusions: PIV was found to be an independent predictive factor in localized RCC. When PIV was included to the model, both UISS and PIV remained significant predictors and also PIV increased the C-index of the model.