Aziz, Atiqullah and Rink, Michael and Gakis, Georgios and Kluth, Luis A. and Dechet, Christopher and Miller, Florian and Otto, Wolfgang and Gierth, Michael and Denzinger, Stefan and Schwentner, Christian and Stenzl, Arnulf and Fisch, Margit and Burger, Maximilian and Fritsche, Hans-Martin (2014) Preoperative C-Reactive Protein in the Serum: A Prognostic Biomarker for Upper Urinary Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy. UROLOGIA INTERNATIONALIS, 93 (3). pp. 352-360. ISSN 0042-1138, 1423-0399
Full text not available from this repository. (Request a copy)Abstract
Objective: To investigate the impact of preoperative serum C-reactive protein (CRP) on clinicopathological features and prognosis in patients with upper tract urothelial cancer (UTUC) after radical nephroureterectomy (RNU). Patients and Methods: Data of 265 patients from three German centers who underwent RNU for UTUC without neoadjuvant chemotherapy between 1990 and 2012 were evaluated. Mean follow-up was 37 Months (interquartile range 9-48). CRP was analyzed as a categorical and continuous variable for the prediction of recurrence-free survival (RFS), disease-specific survival (DSS) and all-cause survival (ACS) using uni- and multivariate Cox regression analyses. Results: The optimal cutoff for CRP was calculated by the Youden index at 0.90 mg/dl. Elevated CRP was significantly associated with pT3/4 and pN+ in a preoperative model including age, gender, tumor nnultifocality, tumor localization and the Eastern Cooperative Oncology Group Performance Status. In a multivariable Cox regression model adjusted for features significant in univariable analysis, categorized and continuous CRP levels were both independent predictors for RFS [hazard ratio (HR) 1.18, p = 0.050; HR 1.03, p = 0.012] and DSS (HR 1.61, p = 0.026; HR 1.06, p = 0.001). Continuous CRP was an independent predictor for ACS (HR 1.05, p = 0.036). Conclusions: Elevated preoperative CRP is significantly associated with aggressive tumor biology and an independent predictor for poor survival after RNU. Preoperative serum CRP represents an easily obtainable and cost-effective marker in UTUC and may help in counseling patients with regard to operative management and/or adjuvant or neoadjuvant therapies. (C) 2014 S. Karger AG, Basel
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INFLAMMATORY RESPONSE; CELL CARCINOMA; OUTCOMES; CANCER; BLADDER; IMPACT; RECURRENCE; SURVIVAL; SURGERY; C-reactive protein; Upper tract urothelial carcinoma; Nephroureterectomy; Prognosis; Survival |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Nov 2019 08:02 |
| Last Modified: | 29 Nov 2019 08:02 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10919 |
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