The Prognostic Role of Serum Albumin Level and Prognostic Nutritional Index in Patients With Localized Clear Cell Renal Cell Carcinoma

Aim:We investigated the relationship between serum albumin level and the prognostic nutritional index (PNI) with tumor histopathology, especially in localized clear cell renal cell carcinoma (ccRCC) patients. Moreover, the prognostic value of these markers in predicting metastatic progression was assessed.Methods:A total of 120 RCC patients who underwent nephrectomy between January 2016 and January 2021 were evaluated. The inclusion criteria were having a ccRCC subtype. Patients who had metastatic disease and N+ status at the time of diagnosis were not included. Serum albumin level and PNI were compared between several tumor histopathology parameters and between patients who exhibited and did not exhibit metastatic progression.Results:The serum albumin level and PNI exhibited significant differences in patients with pathologically higher tumor grade and metastatic progression during follow-up compared to patients with lower tumor grade and non-metastatic follow-up. Serum albumin levels and PNI were correlated with tumor grade and metastasis. In the univariate model, serum albumin and PNI were associated with metastasis [hazard ratio (HR): 0.29; 95% confidence interval (CI): 0.09-0.97; p=0.04; and HR: 0.88; 95% CI: 0.78-0.99; p=0.04].Conclusion:Lower serum albumin and PNI are associated with higher tumor grades in patients with localized ccRCC. Moreover, they were prognostic role in metastatic progression during the follow-up of the patients after nephrectomy.