OBJECTIVE: To assess the impact of preoperative C-reactive protein (CRP) levels on the prognosis in patients with upper urinary tract (UUT) urothelial carcinoma (UC) primarily treated surgically, as it is increasingly recognized that a systemic inflammatory response is associated with the prognosis for patients with various malignancies. PATIENTS AND METHODS: The clinical records of 130 patients treated surgically for UUT-UC were reviewed retrospectively. An elevated CRP was defined as >0.5 mg/dL. Actuarial survival curves were calculated by Kaplan-Meier method, with the difference between curves evaluated using the log-rank test. A multivariate analysis was used to identify prognostic factors, with Cox's proportional hazard model. RESULTS: The median (range) follow-up was 47 (3-190) months. The preoperative serum CRP level was elevated in 24 patients (23%). There were significant associations between CRP level and haemoglobin concentrations, pathological T stage, tumour grade, lymph node involvement and lymphovascular invasion. The 5-year disease-specific and recurrence-free survival rates of 24 patients with elevated CRP were significantly worse than those of the 106 with no CRP elevation (both P < 0.001). On multivariate analysis, preoperative CRP level, pathological T stage and lymph node involvement were significant prognostic factors for disease-specific and recurrence-free survival. CONCLUSION: This study indicated that an elevated preoperative CRP level predicts a poor survival in patients with UUT-UC.
OBJECTIVE: To assess the impact of preoperative C-reactive protein (CRP) levels on the prognosis in patients with upper urinary tract (UUT) urothelial carcinoma (UC) primarily treated surgically, as it is increasingly recognized that a systemic inflammatory response is associated with the prognosis for patients with various malignancies. PATIENTS AND METHODS: The clinical records of 130 patients treated surgically for UUT-UC were reviewed retrospectively. An elevated CRP was defined as >0.5 mg/dL. Actuarial survival curves were calculated by Kaplan-Meier method, with the difference between curves evaluated using the log-rank test. A multivariate analysis was used to identify prognostic factors, with Cox's proportional hazard model. RESULTS: The median (range) follow-up was 47 (3-190) months. The preoperative serum CRP level was elevated in 24 patients (23%). There were significant associations between CRP level and haemoglobin concentrations, pathological T stage, tumour grade, lymph node involvement and lymphovascular invasion. The 5-year disease-specific and recurrence-free survival rates of 24 patients with elevated CRP were significantly worse than those of the 106 with no CRP elevation (both P < 0.001). On multivariate analysis, preoperative CRP level, pathological T stage and lymph node involvement were significant prognostic factors for disease-specific and recurrence-free survival. CONCLUSION: This study indicated that an elevated preoperative CRP level predicts a poor survival in patients with UUT-UC.
Authors: Thomas F Chromecki; Karim Bensalah; Mesut Remzi; Grégory Verhoest; Eugene K Cha; Douglas S Scherr; Giacomo Novara; Pierre I Karakiewicz; Shahrokh F Shariat Journal: Nat Rev Urol Date: 2011-07-05 Impact factor: 14.432
Authors: Hendrik Eggers; Christoph Seidel; Andres Jan Schrader; Rieke Lehmann; Gerd Wegener; Markus A Kuczyk; Sandra Steffens Journal: Med Oncol Date: 2013-09-05 Impact factor: 3.064
Authors: M W Kramer; A Heinisch; G Wegener; M Abbas; C von Klot; I Peters; H Tezval; T R Herrmann; M A Kuczyk; A S Merseburger Journal: Urologe A Date: 2014-02 Impact factor: 0.639