TY - JOUR
T1 - The role of preoperative immune cell metrics in renal cell carcinoma with a tumor thrombus
AU - Sandberg, Maxwell
AU - Namugosa, Mary
AU - Ritts, Rory
AU - Costa, Claudia Marie
AU - Temple, Davis
AU - Hayes, Mitchell
AU - Whitman, Wyatt
AU - Ye, Emily
AU - Refugia, Justin
AU - Ben-David, Reuben
AU - Alerasool, Parissa
AU - Eilender, Benjamin
AU - Zanotti, Rafael Ribeiro
AU - Mourão, Thiago Camelo
AU - Kim, Jung Kwon
AU - Marchiñena, Patricio Garcia
AU - Byun, Seok Soo
AU - Abreu, Diego
AU - Mehrazin, Reza
AU - Spiess, Philippe
AU - de Cassio Zequi, Stenio
AU - Rodriguez, Alejandro
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/8
Y1 - 2024/8
N2 - Introduction: The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy. Methods: Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples t-test, Pearson’s bivariate correlation, and analysis of variance. Results: One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; p < 0.001). Patients with tumor pathology showing perirenal fat invasion had a greater neutrophil count compared to those who did not (7.5 vs 5.5; p = 0.010). Patients with metastatic RCC had a lower LMR compared to those without metastases after surgery (2.5 vs 3.2; p = 0.041). Tumor size, both preoperatively and on gross specimen, had an interaction with multiple immune cell metrics (p < 0.05). Conclusions: Preoperative immune metrics have clinical utility in predicting cancer-specific outcomes for patients with RCC and a tumor thrombus. Additional study is needed to determine the added value of preoperative serum immune cell data to established prognostic risk calculators for this patient population.
AB - Introduction: The objective of this study was to stratify preoperative immune cell counts by cancer specific outcomes in patients with renal cell carcinoma (RCC) and a tumor thrombus after radical nephrectomy with tumor thrombectomy. Methods: Patients with a diagnosis of RCC with tumor thrombus that underwent radical nephrectomy with thrombectomy across an international consortium of seven institutions were included. Patients who were metastatic at diagnosis and those who received preoperative medical treatment were also included. Retrospective chart review was performed to collect demographic information, past medical history, preoperative lab work, surgical pathology, and follow up data. Neutrophil counts, lymphocyte counts, monocyte counts, neutrophil to lymphocyte ratios (NLR), lymphocyte to monocyte ratios (LMR), and neutrophil to monocyte ratios (NMR) were compared against cancer-specific outcomes using independent samples t-test, Pearson’s bivariate correlation, and analysis of variance. Results: One hundred forty-four patients were included in the study, including nine patients who were metastatic at the time of surgery. Absolute lymphocyte count preoperatively was greater in patients who died from RCC compared to those who did not (2 vs 1.4; p < 0.001). Patients with tumor pathology showing perirenal fat invasion had a greater neutrophil count compared to those who did not (7.5 vs 5.5; p = 0.010). Patients with metastatic RCC had a lower LMR compared to those without metastases after surgery (2.5 vs 3.2; p = 0.041). Tumor size, both preoperatively and on gross specimen, had an interaction with multiple immune cell metrics (p < 0.05). Conclusions: Preoperative immune metrics have clinical utility in predicting cancer-specific outcomes for patients with RCC and a tumor thrombus. Additional study is needed to determine the added value of preoperative serum immune cell data to established prognostic risk calculators for this patient population.
KW - Immune
KW - lymphocyte
KW - neutrophil
KW - renal cell carcinoma
KW - thrombus
UR - http://www.scopus.com/inward/record.url?scp=85191293199&partnerID=8YFLogxK
U2 - 10.1177/03915603241248020
DO - 10.1177/03915603241248020
M3 - Article
AN - SCOPUS:85191293199
SN - 0391-5603
VL - 91
SP - 477
EP - 485
JO - Urologia Journal
JF - Urologia Journal
IS - 3
ER -