The Lord ruler has access to his full power and all metals including atium. Szeth has access to a large amount of stormlight, plus access to all of the surges granted by swallowing yelig-nar. Like the fused, he has access to large amounts of voidlight provided by ba-ado-mishram. He has nightblood, and let's assume that he also gets ahold of a set of shardplate. He has had time to master all of his surges.
Given this unlikely, but very possible scenario in which szeth acquires yelig-nar and shardplate, I honestly think that Szeth stands a fair chance against TLR. From stormlight/voidlight he has healing nearly on the level of gold compounding, and the benefits of pewter, plus the boost of the shardplate on top of that. TLR will have to hit him repeatedly to break his shardplate and even do damage. He can counteract the atium with lightweaving to produce an effect similar to what happened when 2 allomancers burning atium face off. This could also serve to make it difficult for TLR to tell where szeth actually is. He can transport himself into the cognitive realm if he needs to avoid an attack by TLR, and could probably reappear behind/next to him. He can soulcast, potentially even soulcasting the air around TLR to stone or something like that which would probably cause TLR to expend a lot of his power to escape either through compounding pewter or tapping weight. And of course if he actually manages to touch TLR, he can harm him in a variety of ways, such as burning him to a crisp with division (though he can probably heal from this a few times at least), lashing him into space (WoB has confirmed this is possible, let's see how long his gold can keep him alive in 1° Kelvin temperatures), or of course just scratching him with nightblood. I highly doubt gold compounding could heal him from that. He can manipulate the matter surrounding him, etc through surges like a bondsmith or a stonewarden. His flight makes him more mobile than TLR.
The main thing I see TLR has going for him in this matchup is his feruchemical speed, not sure how szeth could counteract that, but it would still take TLR quite a few hits to harm him. He could potentially soothe/riot him, but szeth had shown that he can fight effectively while in great emotional distress (weeping as he easily slaughters soldiers and shardbearers).