Prognostic value of pan-immune-inflammation value and body mass index in geriatric patients with metastatic renal cell carcinoma treated with tyrosine kinase inhibitors as first line treatment. A single-center retrospective study

Introduction: Geriatric patients with metastatic renal cell carcinoma (mRCC) are underrepresented in clinical trials. Evaluation of the efficacy of the treatment and assignation of individuals proper prognostic groups is an absolute necessity to guarantee them the possible care. Material and methods: A total of 138 riatric patients with mRCC treated with first -line tyrosine kinase inhibitors (TKIs) at the Maria Sklodowska-Curie National Research Institute of Oncology were retrospectively analyzed to determine whether the body mass index (BMI) pan-immune -inflammation value (PIV) are prognostic values for overall survival (OS) and progression -free survival (PFS) in this type of cancer. For this purpose, Cox's proportional hazard model was used. Results: The median duration of low-up for surviving patients was 46.6 (95% CI: 17.4-75.8) months. The median OS and PFS were respectively 33.8 months (95% CI: 23.8-47.8) and 19.1 months (95% CI: 15.0-23.3). BMI (p = 0.034) and PIV (p < 0.001) were statistically significantly associated with OS, and PIV (p = 0.001) statistically significantly associated with PFS. The risk of death for patients from the high-PIV group (cut-off point: 548) was 3.4 times higher than for those with lower PIV values. The corresponding risk of progression for patients from the high-PIV group was 2.2 times higher. The G8 geriatric screening tool was identified as a prognostic factor. Conclusions: Lower PIV and obesity associated with longer OS in geriatric mRCC patients treated with TKIs in the first line. These factors may considered while making treatment cisions if further studies show the same results.