Session: MP64: Kidney Cancer: Epidemiology & Evaluation/Staging/Surveillance III
MP64-06: Role of inflammatory markers and frailty index as predictors of adverse pathological stage in patients with kidney cancer: a multicenter analysis
Introduction: The purpose of this study was to assess patient frailty and inflammatory state as predictors of adverse pathological outcomes after renal cancer surgery. Methods: We performed an analysis of prospectively collected data of consecutive patients undergoing nephrectomy or patrial nephrectomy in 5 primary care Italian urology centers. Charlson comorbidity score and Frailty index was measured using a simplified frailty index (sFI) with a 5-item score including: (1) diabetes mellitus; (2) functional status; (3) chronic obstructive pulmonary disease; (4) congestive cardiac failure; and (5) hypertension, with a maximum 5-item score meaning high level of frailty. Inflammatory status was evaluated with neutrophil/lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), fibrinogen and albumin levels. Binary logistic regression analysis was used to assess the risk of advanced pathological stage. Results: Two hundred and sixty-two patients were enrolled. Overall, 75/262 (29%) presented a sFI score=3 and 24/262 (9%) presented advanced disease (=3a). sFI =3 (OR: 2,88; 95%CI: 1,22-6,82; p=0,016), Charlson comorbidity index OR=1,24; 95%CI:1,03-1,51; p=0,024), ASA score (OR: 3,22; 95% CI: 1,72-6,06; p=0,001), fibrinogen levels (OR: 1,01; 95%CI 1,00.1,01; p=0,002) and albumin levels (OR=0,80; 95%CI:0,69-0,93; p=0,003) were predictors of adverse pathological outcomes. NLR and MLR were not predictors of adverse pathological outcomes. Variables Advanced pathological Stage OR p Age 1,05 (1,00-1,07) 0,045 CCI 1,24 (1,03-1,51) 0,035 Fibrinogen 1,01(1,00.1,01) 0,002 FI =3 2,88; 1,22-6,82 0,016 ASA score 3,22 (1,72-6,06) 0,001 Albumin Levels 0,80 (0,69-0,93) 0,003 Table: Binary logistic regression analysis for the risk of advanced pathological stage. Conclusions: In patients undergoing surgery for renal cancer, frailty index, inflammatory mediators and comorbidities are predictors of adverse pathological outcomes. Further studies should assess their role in clinical practice and in predictive models. SOURCE OF Funding: No one
