C-reactive protein in patients with advanced metastatic renal cell carcinoma: Usefulness in identifying patients most likely to benefit from initial nephrectomy
ObjectiveC-reactive protein (CRP) is considered a useful serum marker for patients with RCC. However, its clinical utility in advanced metastatic renal cell carcinoma (AM-RCC), particularly in deciding whether to perform nephrectomy at the onset, is not well studied.Patients and
Methods: We retrospectively evaluated 181 patients with AM-RCC, including 18 patients underwent potentially curative surgery, 111 underwent cytoreductive nephrectomy, and 52 received medical treatment only.
CRP cutoff points were determined by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier and Cox regression analyses were used for survival tests.
Results:
ROC analysis suggested that grouping patients according to 3 CRP ranges was a rational model.
Patients with highly elevated CRP ([greater than or equal to]67.0 mg/L) presented remarkably poor prognosis despite treatment (nephrectomy or medical treatment only). Cox regression models demonstrated that risk factors of overall survival for patients who underwent nephrectomy were the CRP ranges defined in this study ([less than or equal to]18.0 mg/L, >18.0 and <67.0 mg/L, and [greater than or equal to]67.0 mg/L), ECOG PS (0, 1, and [greater than or equal to]2), and number of metastatic organ sites (0-1 and [greater than or equal to]2).
The retrospective design is a limitation of this study.
Conclusion:
Our study demonstrated that the serum CRP level is a statistically significant prognostic parameter for patients with AM-RCC. The data also indicated that pretreatment serum CRP level provides useful prognostic information that helps in deciding whether to perform initial nephrectomy for patients with AM-RCC.
Author: Hiroki ItoKoichi ShioiTakayuki MurakamiAkitoshi TakizawaFutoshi SanoTakashi KawaharaNobuhiko MizunoKazuhide MakiyamaNoboru NakaigawaTakeshi KishidaTakeshi MiuraYoshinobu KubotaMasahiro Yao Credits/Source: BMC Cancer 2012, 12:337
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