Preoperative anaemia and thrombocytosis predict adverse prognosis in non‐metastatic renal cell carcinoma with tumour thrombus

BMC Urology

Lulin Ma¹  Cheng Liu¹  Lei Liu²  Hongxian Zhang²  Ruotao Xiao³  Wei He³  Chuxiao Xu³ 

[1] Department of Urology, Peking University Third Hospital, No.49 North Garden Road, Haidian District, 100191, Beijing, People’s Republic of China;Peking University Health Science Centre, 100191, Beijing, People’s Republic of China;Peking University Health Science Centre, 100191, Beijing, People’s Republic of China;Department of Urology, Peking University Third Hospital, No.49 North Garden Road, Haidian District, 100191, Beijing, People’s Republic of China;

关键词: Anaemia;    Thrombocytosis;    Renal cell carcinoma;    Tumour thrombus;    Prognosis;   

DOI  :  10.1186/s12894-021-00796-6

来源: Springer

【 摘 要 】

Background This study aimed to determine the prognostic value of preoperative blood parameters in renal cell carcinoma (RCC) and tumour thrombus (TT) patients that were surgically treated.MethodWe retrospectively analysed clinicopathological data and blood parameters of 146 RCC and TT patients that were surgically treated. Univariate or multivariate Cox regression analyses were performed to determine the risk factors associated with progression-free survival (PFS) and overall survival (OS). Kaplan-Meier analysis and logistic regression were performed to study the risk factors. Receiver operating characteristic curves were applied to test improvements in the predictive accuracy of the established prognosis score.ResultsOn univariate and multivariate analysis, anaemia (HR 2.873, P = 0.008) and lymph node metastasis (HR 4.811, P = 0.015) were independent prognostic factors linked to OS. Besides, thrombocytosis (HR 2.324, P = 0.011), histologic subtype (HR 2.835, P = 0.004), nuclear grade (HR 2.069, P = 0.033), and lymph node metastasis (HR 5.739, P = 0.001) were independent prognostic factors associated with PFS. Kaplan–Meier curves revealed that patients with anaemia exhibited worse OS than those without it (P = 0.0033). Likewise, patients with thrombocytosis showed worse PFS than those without it (P < 0.0001). Adding the anaemia and thrombocytosis to the SSIGN score improved its predictive accuracy related to OS and PFS. Preoperative anaemia was linked to more symptom at presentation (OR 3.348, P = 0.006), longer surgical time (OR 1.005, P = 0.001), more blood loss (OR 1.000, P = 0.018), more transfusion (OR 2.734, P = 0.004), higher thrombus level (OR 4.750, P = 0.004) and higher nuclear grade (OR 3.449, P = 0.001) while thrombocytosis was associated with more symptom at presentation (OR 7.784, P = 0.007).ConclusionsPreoperative anaemia and thrombocytosis were adverse prognostic factors in non-metastatic RCC patients with TT. Also, both preoperative anaemia and thrombocytosis can be clinically used for risk stratification of non-metastatic RCC and TT patients.

【 授权许可】

CC BY