• Mehmet Uzun, Eda Caliskan Yildirim, Ferhat Ekinci, and Huseyin Salih Semiz.
• Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkey.
• J Coll Physicians Surg Pak. 2022 Nov 1; 32 (11): 1425-1429.

ObjectiveTo evaluate the effect of pretreatment C-reactive protein (CRP)/Albumin ratio (CAR) on prognosis and its association with IMDC (International metastatic renal cell carcinoma database consortium) risk score and overall survival (OS) in metastatic renal cell carcinoma (mRCC) patients.Study DesignDescriptive study.Place And Duration Of StudyDepartment of Medical Oncology, Dokuz Eylul University, Izmir, Turkey, between 2007 and 2020.MethodologyClinico-pathological and treatment-related data of mRCC patients were retrospectively evaluated and included in the study. CAR was used as a prognostic inflammatory score. CAR threshold value for OS has been obtained by ROC analysis. The prognostic value of CAR was tested using Kaplan-Meier and Cox-regression models. IMDC-CAR model was created by adding CAR to IMDC risk stratification.ResultsOS was 91 months in patients with CAR below the threshold value of 0.072 (<0.072), while OS was 51 months in patients with CAR of 0.072 and above (p=0.005). According to IMDC risk stratification, intermediate and poor risk groups showed similar survival times (p>0.05). However, when CAR was added to the IMDC risk score in the intermediate group, it was divided into 3 subgroups with different prognoses (p=0.02).ConclusionCAR is an independent predictor of OS in mRCC patients. In this study, it has been demonstrated that more accurate prognosis prediction could be made by adding CAR to IMDC indicators in the intermediate risk group, which constitutes a highly heterogeneous group according to IMDC risk stratification.Key WordsRenal cell cancer, Albumin, C-reactive protein, IMDC, Prognosis.

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