title: Systemic inflammation score predicts postoperative prognosis of patients with clear-cell renal cell carcinoma.
abstract: BACKGROUND
  Growing evidence indicates that inflammation has a crucial role in the development and progression of cancer. We developed a novel systemic inflammation score (SIS) based on preoperative serum albumin and lymphocyte-to-monocyte ratio (LMR), and examined its prognostic value for patients with clear-cell renal cell carcinoma (ccRCC) after surgery.
  
  
  METHODS
  The study comprised 441 ccRCC patients undergoing nephrectomy between 2008 and 2009 in a single centre. The SIS was developed and its associations with clinicopathological features and overall survival (OS) were evaluated.
  
  
  RESULTS
  The SIS consisted of serum albumin and LMR that were both retained as independent indicators adjusting for other haematological and laboratory markers of systemic inflammation responses and traditional clinicopathological features. A high SIS was significantly associated with aggressive tumour behaviours and served as an independent prognostic factor of reduced OS. Furthermore, the SIS could significantly stratify patient prognosis in different tumour stages and Mayo Clinic stage, size, grade and necrosis scores. Incorporation of the SIS into a prognostic model including TNM stage, Fuhrman grade and lymphovascular invasion generated a nomogram, which predicted accurately 3- and 5-year survival for ccRCC patients.
  
  
  CONCLUSIONS
  The SIS as a potentially powerful prognostic biomarker might improve traditional clinicopathological analysis to refine clinical outcome prediction for ccRCC patients after surgery.
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: An
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Urology, Shanghai Cancer Center, Fudan University, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Lin
authors.affiliation: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Xu
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology; D009336:Necrosis / Q000473:pathology; D009392:Nephrectomy / Q000379:methods; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies