Predictive value of SIRI and SII for metastases in RCC: A prospective clinical study

Background: Prediction of possible postoperative metastases of renal cell carcinoma is a compelling challenge for clinicians. In this prospective cross-sectional clinical study we aimed to determine the efficiency of the preoperative hematological markers namely SIRI (systemic inflammatory response index) and SII (systemic inflammatory index) for renal cell carcinoma to predict the possibility of postoperative metastases. Methods: : 72 patients who were diagnosed with RCC and underwent surgery in Urology Clinic of Istanbul Training and Research Hospital or were included in the treatment planning in the Medical Oncology Clinic of Istanbul Training and Research Hospital between July 2022 and January 2023 were included in the study. All cases with diagnoses of renal cell carcinoma were obtained from the hospital records. Patients with secondary malignancy, hematological or rhemotological disorders or ones with the recent blood product transfusion or diagnoses of infection within the 1-month-time of diagnoses were excluded. The data within complete blood counts analysed just before the time of renal biopsy or surgery were analysed for SIRI and SII calculations. A total of 22 metastatic and 50 non-metastatic RCC patients were included. SIRI and SII values were compared among groups to seek the change of values in case of meastatasis and in non-metastatic patients a cut-off value were sought to indicate malignancy before pathological diagnosis. Results: : Mean age of non-metastatic RCC patients were 60.12+/-11.55 years and metastatic RCC patients were 60.25+/-11.72. Histological sub-types of the RCC specimens were clear cell (72%), chromophobe cell (17%), papillary cell (7%) and others (4%). Median SIRI values for non-metastatic and metastatic groups were 1.26 and 2.1 (mean+/-S.D. 1.76 +/-1.9 and 3.12+/-4.22 respectively (p<0.05). Median SII values for non-metastatic and metastatic groups were 566 and 1434 (mean+/-S.D. 870 +/-1019 and 1537+/-917) respectively(p<0.001). Conclusions: : SIRI and SII indexes seem to show a moderate efficiency to show metastases in RCC. Trial Registration: - Approved by the Health Sciences University Istanbul Health Practice and Research Center, Clinical Research and Ethics Committee (22.07.2022/Desicion Number: 235)