Improving the accuracy of pre-operative survival prediction in renal cell carcinoma with C-reactive protein
Background: Validated objective biomarkers are needed for patients with renal cell carcinoma (RCC) to guide patient management and define high-risk populations for follow-up or for therapeutic purposes. Methods: Patients undergoing nephrectomy for RCC ( n =286 all stages, 84% with conventional clear...
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| Published in: | British journal of cancer Vol. 103; no. 11; pp. 1649 - 1656 |
|---|---|
| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
Nature Publishing Group UK
23-11-2010
Nature Publishing Group |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background:
Validated objective biomarkers are needed for patients with renal cell carcinoma (RCC) to guide patient management and define high-risk populations for follow-up or for therapeutic purposes.
Methods:
Patients undergoing nephrectomy for RCC (
n
=286 all stages, 84% with conventional clear cell type) were included with a median duration follow-up of 5 years. The prognostic significance of pre-operative haematological and biochemical variables, including C-reactive protein (CRP) values were examined and whether they added additional information to a recently published pre-operative scoring system was determined.
Results:
C-reactive protein was the most significant predictor of overall survival (OS;
χ
2
=50.9,
P
<0.001). Five-year OS for patients with CRP⩽15 mg l
−1
vs
>15 mg l
−1
was 72% (95% CI 65–78%) and 33% (95% CI 23–44%), respectively. Similar results were seen for cancer-specific survival (CSS) and disease-free survival. On multivariate analysis, CRP remained highly significant for CSS (
χ
2
=17.3,
P
<0.0001) and OS (
χ
2
=9.8,
P
<0.002), in addition to other pre-operative variables including log of neutrophil/lymphocyte ratio, red blood cell count and white cell count. C-reactive protein was significant in addition to the pre-operative nomogram score (
χ
2
=12.5,
P
=0.0004 for OS,
χ
2
=16.2,
P
=0.0001 for CSS and
χ
2
=8.6,
P
=0.003 for DFS) and was still significant when other pre-operative variables were included.
Conclusion:
C-reactive protein and other haematological and biochemical variables have independent prognostic significance in RCC and may enhance pre-operative scoring systems. |
|---|---|
| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 These authors contributed equally to this work. |
| ISSN: | 0007-0920 1532-1827 |
| DOI: | 10.1038/sj.bjc.6605973 |