PATIENT FACING SYSTEMS Can we Predict Preoperative Tumor Aggressivity with Hemogram Parameters in Renal Cell Carcinoma? a Novel Calculation Method Murat Uçar 1 & Sedat Soyupek 2 & Taylan Oksay 2 & Alper Özorak 2 & Ali Akkoç 1 & Murat Topçuoğlu 1 & Murat Demir 2 & Alim Koşar 2 Received: 27 August 2019 /Accepted: 17 October 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract We aim to investigate the prognostic significance of the hemoglobin X lymphocyte / neutrophil ratio (HLNR) and hemoglobin x lymphocyte / platelet ratio (HLPR) with tumor aggressivity in patients with renal cell carcinoma. We retrospectively analyzed 127 patients’ data who had diagnosed as renal cell carcinoma between 2008 and 2019 in Suleyman Demirel University Hospital. Tumor and patient characteristics, hemoglobin, neutrophil, lymphocyte, platelet values HLNR and HLPR were calculated in preoperative hemogram parameters. The relationship between tumor pathological stage, Fuhrman nuclear grade and tumor necrosis with HLPR and HLNR analyzed with statistically. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLNR. P values are 0.003, 0.012 and 0.015 respectively. HLNR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. There was a negative correlation between pathologic stage, Fuhrman nuclear grade and tumor necrosis with HLPR. P values are 0.001, 0.014 and 0.047 respectively. HLPR was lower in patients with high pathologic stage, high Fuhrman nuclear grade and accompanying tumor necrosis positiveness. High pathological stage, high Fuhrman nuclear grade and existence of tumor necrosis are associates with preoperative low HLNR and low HLPR in renal cell carcinoma patients. They can be used as prognostic markers in patients with renal mass preoperatively. Keywords Kidney . Carcinoma renal cell . Hematologic tests . Prognosis Introduction Estimated incidence of kidney cancer annually in the US is 5% for males and 3% for females [1]. The likelihood of de- veloping invasive kidney cancer from birth to death is 2.1% in men and 1.2% in women. Because kidney cancers have re- cently been diagnosed earlier, the possibility of invasive can- cer has decreased. Renal cell carcinomas (RCC) are com- prised 85% of malignant renal tumors [2]. RCC has 3 main subtypes; clear cell, papillary cell and chromophobe cell and the most common type is clear cell carcinoma [3]. Tumor aggressivity in renal cell carcinoma varies accord- ing to tumor pathological stage, histological subtype, Fuhrman nuclear grade. The pathological stage of the tumor is evaluated according to size of the tumor, invasion of tumor to capsule or surrounding tissues, involvement of lymph nodes and distant metastasis [4]. RCC subtype, tumor grade, sarcomatoid features, microvascular invasion, tumor necrosis and Fuhrman nuclear grade are other predictors of prognosis in RCC [5]. Changes in acute inflammation markers are usually de- tected in a patient with cancer. In some cancers, acute inflammatory changes occur before cancer, in some others oncogenic variance triggers acute inflammation [ 6]. Cytokines released from tumor tissue play a role in this systemic inflammatory response. Leukocytosis shows an inflammatory reaction in the body. GM – CSF can cause leukocytosis in a patient with renal cell cancer [ 7]. Lymphocytes, neutrophils, monocytes, thrombocytes, C- This article is part of the Topical Collection on Patient Facing Systems * Murat Uçar murat.ucar@alanya.edu.tr 1 Alanya Alaaddin Keykubat University, School of Medicine, Antalya, Turkey 2 Süleyman Demirel University, School of Medicine, Isparta, Turkey Journal of Medical Systems (2020) 44:19 https://doi.org/10.1007/s10916-019-1491-2