Introduction:
The present study investigated the prognostic value of neutrophil-to-mean platelet volume ratio (NMPVR) for overall (OS) and cancer-specific survival (CSS) in patients treated with nephrectomy for localized clear cell renal cell carcinoma (ccRCC).

Material and methods:
Medical records of 344 consecutive patients who underwent partial or radical nephrectomy for M0 ccRCC were retrospectively analyzed. Based on the median NMPVR, the study population was divided into two groups: the high NMPVR group with NMPVR higher than or equal to the median, and the low NMPVR group with NMPVR lower than the median. Comparisons of baseline characteristics and laboratory and pathological findings were performed. Kaplan-Meier survival curves and Cox regression model analysis were used to assess the prognostic value of the NMPVR.

Results:
Patients with higher NMPVR values were more frequently diagnosed with advanced disease, tumor necrosis and higher tumor grade. The OS and CSS were significantly shorter in patients with NMPVR ≥ 0.41 compared to patients with NMPVR < 0.41. Inclusion of NMPVR in multivariable models of OS and CSS with other confounding variables determined categorized NMPVR as an independent prognostic factor for both endpoints.

Conclusions:
Pretreatment NMPVR ≥ 0.41 was associated with lower OS and CSS. NMPVR might be applied as a cheap and uncomplicated prognostic indicator in localized ccRCC patients treated with a primary surgical approach.