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

In this prospective cross-sectional clinical study, we aimed to determine the efficiency of preoperative hematological markers namely SIRI (systemic inflammatory response index) and SII (systemic inflammatory index) for renal cell cancer to predict the possibility of postoperative metastases.

Istanbul Education and Research Hospital, Clinic of Urology and Medical Oncology in the clinic between the dates of June 2022 to 2023 February, a diagnosis of renal cell cancer by surgical or medical oncology units imported into the treatment planning of 72 patients were included in the study. All cases with diagnoses of renal cell carcinoma were searched from hospital records. Patients with secondary malignancy, hematological or rheumatological disorders or ones with recent blood product transfusion or diagnoses of infection within the 1-month-time of diagnoses were excluded for data analyses. The data within complete blood counts (CBC) analyzed just before the time of renal biopsy or surgery were studied for SIRI and SII calculations. Twenty-two metastatic and 50 non-metastatic RCC patients were included. SIRI and SII values were compared among groups to seek change of values in case of metastasis and in non-metastatic patients a cut-off value were sought to indicate malignancy before pathological diagnosis.

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). AUC for detection of metastasis were 0.809 for SII and 0.737 for SIRI.

SIRI and SII indexes seem to show a moderate efficiency to show metastases in RCC.