PREDICTORS OF RECURRENCE AND SURVIVAL IN PATIENTS WITH METASTATIC RENAL CELL CARCINOMA UNDERGOING COMPLETE SURGICAL RESECTION

INTRODUCTION AND OBJECTIVES:The aim of the present study is to evaluate the prognostic significance of the Glasgow Prognostic Score (GPS) in metastatic renal cell carcinoma (mRCC) patients treated with cytoreductive nephrectomy (CN) and the accuracy of the GPS as a prognostic factor.METHODS: We retrospectively analyzed the data of patients who underwent CN for mRCC between March 1984 and August 2015.In accordance with the GPS criteria, the patients were classified into three groups, as follows: GPS 0: CRP 1.0 mg/dl and albumin 3.5 g/ dl, GPS 1: CRP >1.0 mg/dl or albumin <3.5 g/dl, and GPS 2: CRP >1.0 mg/dl and albumin <3.5 g/dl.RESULTS: We enrolled 170 patients (72% male; median age, 63.5 years).Fifty-six (33%), 67 (39%), and 47 (28%) patients had GPSs of 0, 1, and 2, respectively.The median OSs after CN were 52.4,19.1, and 8.9 months for patients with a GPS of 0, 1, and 2, respectively (P < 0.0001).In addition to the GPS, age, Eastern Cooperative Oncology Group performance status (ECOG-PS), histology, sarcomatoid change, clinical nodal stage, liver metastasis were included in the Cox hazards regression model.Multivariate analysis of these factors revealed that the GPS was an independent prognostic factor of OS (P < 0.0001).The Harrell's concordance index in the multivariate prognostic model based on age, ECOG-PS, histology, sarcomatoid change, clinical nodal stage, and liver metastasis was 0.662, which increased to 0.674 after the inclusion of GPS.CONCLUSIONS: GPS represents an independent prognostic factor for patients who undergo CN for mRCC.