The Relationship Between Preoperative Inflammatory Indexes and Adherent Perinephric Fat in Laparoscopic Partial Nephrectomy
The Preoperative Predictive Factors for Laparoscopic Partial Nephrectomy
Sažetak
Background/Aim: Partial nephrectomy (PN) is favoured for cT1a renal tumours. However, factors like adherent perinephric fat (APF), linked to prolonged operation time due to chronic inflammation are often overlooked. The objective of this study was to assess the relationship between the composite inflammatory index and APF in patients with renal cell carcinoma (RCC) prior to laparoscopic partial nephrectomy (LPN).
Methods: The retrospective analysis included 189 LPN patients from April 2015 to June 2021, categorised by APF presence. Demographic, laboratory and radiological data assessed composite inflammatory index and Mayo adhesion probability (MAP) scores. Chi-Square and Mann-Whitney U-test analysed categorical and continuous variables. Area under curve (AUC) measured parameter discrimination. Logistic regression identified APF predictive factors.
Results: APF was present in 90 patients (47.6 %). The APF-positive group had significantly higher C-reactive protein (CRP) levels and longer operation times (p = 0.016 and p = 0.001, respectively). Elevated MAP scores and systemic inflammatory index (SII) values were also observed in the APF-positive group (p = 0.002 and p = 0.001, respectively). Receiver operating characteristic (ROC) analysis determined SII's cut-off at 600 (sensitivity: 60.0 %, specificity: 60.6 %, AUC: 0.640, p = 0.001), MAP score at 2.5 (sensitivity: 67.8 %, specificity: 64.5 %, AUC: 0.640, p < 0.001) and operation time at 122.5 min (sensitivity: 74.4 %, specificity: 67.7 %, AUC: 0.807, p < 0.001).
Conclusion: Presented results indicate that SII is linked to APF in patients undergoing LPN and may serve as an independent predictor of APF positivity.
Reference
Abu-Ghanem Y, Fernández-Pello S, Bex A, Ljungberg B, Albiges L, Dabestani S, et al. Limitations of available studies prevent reliable comparison between tumour ablation and partial nephrectomy for patients with localised renal masses: a systematic review from the European Association of Urology Renal Cell Cancer Guideline Panel. Eur Urol Oncol. 2020 Aug;3(4):433-52. doi: 10.1016/j.euo.2020.02.001.
Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009 Sep;182(3):844-53. doi: 10.1016/j.juro.2009.05.035.
Ficarra V, Novara G, Secco S, Macchi V, Porzionato A, De Caro R, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009 Nov;56(5):786-93. doi: 10.1016/j.eururo.2009.07.040.
Davidiuk AJ, Parker AS, Thomas CS, Leibovich BC, Castle EP, Heckman MG, et al. Mayo adhesive probability score: an accurate image-based scoring system to predict adherent perinephric fat in partial nephrectomy. Eur Urol. 2014 Dec;66(6):1165-71. doi: 10.1016/j.eururo.2014.08.054.
Kocher NJ, Kunchala S, Reynolds C, Lehman E, Nie S, Raman JD. Adherent perinephric fat at minimally invasive partial nephrectomy is associated with adverse peri-operative outcomes and malignant renal histology. BJU Int. 2016 Apr;117(4):636-41. doi: 10.1111/bju.13378.
Laukhtina E, Schuettfort VM, D'Andrea D, Pradere B, Quhal F, Mori K, et al. Selection and evaluation of preoperative systemic inflammatory response biomarkers model prior to cytoreductive nephrectomy using a machine-learning approach. World J Urol. 2022 Mar;40(3):747-54. doi: 10.1007/s00345-021-03844-w.
Wang L, Wang C, Wang J, Huang X, Cheng Y. A novel systemic immune-inflammation index predicts survival and quality of life of patients after curative resection for esophageal squamous cell carcinoma. J Cancer Res Clin Oncol. 2017 Oct;143(10):2077-86. doi: 10.1007/s00432-017-2451-1.
Noh H, Eomm M, Han A. Usefulness of pretreatment neutrophil to lymphocyte ratio in predicting disease-specific survival in breast cancer patients. J Breast Cancer. 2013 Mar;16(1):55-9. doi: 10.4048/jbc.2013.16.1.55.
Luis-Cardo A, Herranz-Amo F, Rodríguez-Cabero M, Quintana-Álvarez R, Esteban Labrador L, Rodríguez-Fernández E, et al. Laparoscopic nephron sparing surgery and radical nephrectomy in cT1 renal tumors. Comparative analysis of complications and survival. Actas Urol Esp (Engl Ed). 2022 Jul-Aug;46(6):340-7. doi: 10.1016/j.acuroe.2021.11.005.
Yao Y, Gong H, Pang Y, Gu L, Niu S, Xu Y, et al. Risk factors influencing the thickness and stranding of perinephric fat of Mayo adhesive probability score in minimally invasive nephrectomy. Med Sci Monit. 2019 May 23;25:3825-31. doi: 10.12659/MSM.916359.
Kawamura N, Saito K, Inoue M, Ito M, Kijima T, Yoshida S, et al. Adherent perinephric fat in Asian patients: predictors and impact on perioperative outcomes of partial nephrectomy. Urol Int. 2018;101(4):437-42. doi: 10.1159/000494068.
Macleod LC, Hsi RS, Gore JL, Wright JL, Harper JD. Perinephric fat thickness is an independent predictor of operative complexity during robot-assisted partial nephrectomy. J Endourol. 2014 May;28(5):587-91. doi: 10.1089/end.2013.0647.
Martin L, Rouviere O, Bezza R, Bailleux J, Abbas F, Schott-Pethelaz AM, et al. Mayo adhesive probability score is an independent computed tomography scan predictor of adherent perinephric fat in open partial nephrectomy. Urology. 2017 May;103:124-8. doi: 10.1016/j.urology.2016.11.043.
Asahi Y, Kubonishi I, Imamura J, Kamioka M, Matsushita H, Furihata M, et al. Establishment of a clonal cell line producing granulocyte colony-stimulating factor and parathyroid hormone-related protein from a lung cancer patient with leukocytosis and hypercalcemia. Jpn J Cancer Res. 1996 May;87(5):451-8. doi: 10.1111/j.1349-7006.1996.tb00245.x.
Alexandrakis MG, Passam FH, Perisinakis K, Ganotakis E, Margantinis G, Kyriakou DS, et al. Serum proinflammatory cytokines and its relationship to clinical parameters in lung cancer patients with reactive thrombocytosis. Respir Med. 2002 Aug;96(8):553-8. doi: 10.1053/rmed.2002.1328.
Nakamoto S, Ohtani Y, Sakamoto I, Hosoda A, Ihara A, Naitoh T. Systemic immune-inflammation index predicts tumor recurrence after radical resection for colorectal cancer. Tohoku J Exp Med. 2023 Nov 25;261(3):229-38. doi: 10.1620/tjem.2023.J074.
Luo Z, Wang W, Xiang L, Jin T. Association between the systemic immune-inflammation index and prostate cancer. Nutr Cancer. 2023;75(10):1918-25. doi: 10.1080/01635581.2023.2272800.
Kars A, Sahin A, Kılıc K, Sakat MS, Bilen A. Systemic immune inflammation index in differentiated thyroid cancers. Acta Otorhinolaryngol Ital. 2022 Apr;42(2):150-4. doi: 10.14639/0392-100X-N1665.
Ma T, Cong L, Ma Q, Huang Z, Hua Q, Li X, et al. Study on the correlation between preoperative inflammatory indexes and adhesional perinephric fat before laparoscopic partial nephrectomy. BMC Urol. 2021 Dec 10;21(1):174. doi: 10.1186/s12894-021-00940-2.
Narita S, Kumazawa T, Tsuchiya N, Mingguo H, Saito M, Inoue T, et al. Host-related risk factors for adherent perinephric fat in healthy individuals undergoing laparoscopic living-donor nephrectomy. Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):e69-e73. doi: 10.1097/SLE.0000000000000433.
Dariane C, Le Guilchet T, Hurel S, Audenet F, Beaugerie A, Badoual C, et al. Prospective assessment and histological analysis of adherent perinephric fat in partial nephrectomies. Urol Oncol. 2017 Feb;35(2):39.e9-39.e17. doi: 10.1016/j.urolonc.2016.09.008.
Feng L, Xu R, Lin L, Liao X. Effect of the systemic immune-inflammation index on postoperative complications and the long-term prognosis of patients with colorectal cancer: a retrospective cohort study. J Gastrointest Oncol. 2022 Oct;13(5):2333-9. doi: 10.21037/jgo-22-716.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).