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Monocyte to lymphocyte ratios and cancer-specific mortality for patients with renal cell carcinoma and inferior vena cava tumor thrombus.

2024; Lippincott Williams & Wilkins; Volume: 42; Issue: 4_suppl Linguagem: Inglês

10.1200/jco.2024.42.4_suppl.444

1527-7755

Maxwell Sandberg, Rory Ritts, Mary Namugosa, Davis L. Temple, Wyatt Whitman, Claudia Marie Costa, Justin Refugia, Benjamin Eilender, Reza Mehrazin, Rafael Ribiero Zanotti, Patricio García Marchiñena, Stênio de Cássio Zéqui, Alejandro Rodríguez,

Cancer Diagnosis and Treatment

444 Background: Renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus carries a poor prognosis and presents complex medical management to urologists. Long-term data examining RCC with IVC tumor thrombus is sparse. Specifically, markers predicting cancer-specific survival are lacking. Recently, immune cell markers in cancer, such as neutrophils, lymphocytes, and monocytes, have come into focus. These cell counts and/or ratios may provide a window into cancer-specific outcomes. The purpose of this study was to examine the use of immune cell ratios in patients with RCC and IVC tumor thrombus to predict survival outcomes through a collaboration project across North and South America. Methods: Patients were included in this study if they had a diagnosis of RCC with IVC tumor thrombus and underwent nephrectomy with IVC thrombectomy for their RCC. Data was reviewed and entered into a multi-institutional/continental database. Complete blood counts taken as close to the date prior to/date of surgery were used to calculate immune cell ratios. Neutrophil to (/) lymphocyte ratios were done by dividing patients’ neutrophil cell count by their lymphocyte count. Monocyte/lymphocyte ratios were calculated in the same manner. Independent samples t-test was used to test for significance in cause of death post-operatively (RCC versus non-RCC cause) based on immune cell ratio. Results: There were 107 patients included in the study with long-term follow-up data (Mean: 2.6 years; Range: 0-16-years). Of all patients, 43/107 died by the end of the study, with 31/43 (72.1%) dying due to RCC and 12/43 (27.9%) from other causes. No difference existed in neutrophil/lymphocyte ratios based on cause of death (p=0.260). Monocyte/lymphocyte ratios were significantly lower in those who died from RCC relative to another cause (p=0.035). Conclusions: Immune cell ratios may have a role in predicting death from RCC. In our study, monocyte/lymphocyte ratios were significantly lower in patients who died from RCC compared to death from other reasons. Our results stem from a multi-continental/institutional study, and thus hold clinical utility as an increased focus is turned towards including diverse populations in research. Urologists may consider monocyte/lymphocyte ratios in the future when managing patients with RCC and an IVC thrombus. [Table: see text]