Predicting the prognosis of patients with renal cell carcinoma based on systemic immune inflammatory index and prognostic nutritional index.

Purpose: This study aimed to evaluate the prognostic value of preoperative systemic immune inflammatory index (SII) and prognostic nutritional index (PNI) in patients with renal cell carcinoma (RCC) undergoing surgery, and to establish a nomogram for predicting overall survival (OS).

Methods: We retrospectively analyzed clinical data from 240 RCC patients who underwent surgery. SII and PNI values were calculated, and optimal cutoff value were determined by receiver operating characteristic curves. Patients were classified into high and low SII/PNI groups. Survival outcomes were assessed using Kaplan-Meier analysis and log-rank tests. Univariate and multivariate Cox regression models were used to identify independent prognostic factors, which were incorporated into a nomogram. The model's accuracy and discrimination were evaluated by the consistency index (C-index) and calibration curves.

Results: The 1-, 3- and 5-year survival rates were significantly higher in low SII group were (98.10%, 92.30%, and 87.20%) compared to the high SII group (90.00%, 72.90%, and 57.40%), and higher in the high PNI group (97.60%, 93.00%, and 87.60%) compared to the low PNI group (86.90%, 67.90%, and 40.80%; P < 0.001). Multivariate Cox regression model analysis showed that SII, PNI, hemoglobin, tumor necrosis, surgical method, pathological type, AJCC stage and Fuhrman grade were independent prognostic factors. The nomogram model demonstrated excellent predictive ability with a C index was 0.915.

Conclusions: Preoperative SII and PNI are independent predictors of postoperative prognosis in RCC patients. The constructed nomogram based on multiple factors provides accurate individualized survival predictions.