Savaş GÖKÇEK, Mehmet UZUN, Faruk Recep ÖZALP, Ferhat EKİNCİ, Ece ŞAHİN HAFIZOĞLU, Hüseyin Salih SEMİZ
Journal of Basic and Clinical Health Sciences - 2026;10(3):446-456
Background and Purpose: The Lung Immune Prognostic Index (LIPI), based on derived neutrophil-to-lymphocyte ratio (dNLR) and Lactate Dehydrogenase (LDH), is a recognized biomarker in various malignancies. However, its incremental value over the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score in metastatic renal cell carcinoma (mRCC) remains debated. This study evaluated the prognostic role of LIPI on mRCC and its association with clinicopathological features. Methods: We retrospectively analyzed 304 mRCC patients treated between 2010 and 2023 at two oncology centers. Patients were stratified into good, intermediate, and poor LIPI groups. Survival outcomes were assessed using Kaplan-Meier and Cox regression. The prognostic performance of LIPI was compared and combined with the IMDC model using the Akaike Information Criterion (AIC). Results: Of 304 patients, 35.2% were good, 44.1% intermediate, and 17.8% poor LIPI risk. Poor LIPI was significantly associated with liver metastasis (p=0.009) and poor IMDC risk (p=0.001). Median overall survival was 45, 30, and 14 months for good, intermediate, and poor groups, respectively (p < 0.001). While IMDC showed better model fit (AIC: 1547.2 vs 1560.0), adding LIPI to the IMDC model provided a significant incremental contribution (p=0.047). In the combined model, poor LIPI remained significantly associated with worse overall survival after adjustment for IMDC (HR=1.72, p=0.013). Conclusion: LIPI is a simple tool for prognostic stratification in mRCC, correlating with high-risk features like liver metastases. Although IMDC remains the primary prognostic model, LIPI provides a modest but statistically significant incremental contribution, suggesting it captures additional biological information.
