Elevated preoperative inflammatory ratios (NLR/PLR) predict adverse pathology and poor surgical outcomes in metastatic renal cell carcinoma: a retrospective analysis

OBJECTIVE: To clarify the clinical utility of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in metastatic renal cell carcinoma (mRCC). METHODS: We enrolled 240 RCC patients, including 100 primary RCC (pRCC) and 140 mRCC cases. Peripheral venous blood was sampled for NLR and PLR quantification. NLR/PLR correlations with clinicopathological features and their impacts on surgical outcomes were discussed. RESULTS: We determined significant NLR and PLR elevations in mRCC versus pRCC cases. NLR had an area under the curve (AUC) of 0.710 while PLR exhibited an AUC of 0.716 in diagnosing mRCC. PLR correlated intimately with clinical staging and Fuhrman grading, while NLR was additionally linked to the metastatic site. In clinical stage discrimination, the AUC was 0.679 for NLR and 0.634 for PLR, with corresponding AUC of 0.656 and 0.612 in Fuhrman grade diagnosis. Additionally, the postoperative prognosis of mRCC patients was significantly and independently influenced by clinical staging, Fuhrman grading, NLR, and PLR. CONCLUSION: NLR and PLR, showing up-regulated expression in mRCC, correlate intimately with advanced clinical staging and higher Fuhrman grading. Clinical stage III-IV, Fuhrman grade (3-4), elevated NLR (≥2.76), and high PLR (≥166.50) are predictors of unfavorable surgical outcomes in mRCC.