Prognostic Value of the Lung Immune Prognostic Index in Metastatic Renal Cell Carcinoma: A Multicentre Cohort Study

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 in 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