C-reactive protein is an informative predictor of renal cell carcinoma-specific mortality

A European study of 313 patients

Authors

  • Pierre I. Karakiewicz MD,

    Corresponding author
    1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
    2. Department of Urology, University of Montreal, Montreal, Quebec, Canada
    • Associate Professor and Senior Outcomes Scientist, Director, Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center (CHUM), 1058 rue St-Denis, Montreal, Quebec, Canada H2X 3J4
    Search for more papers by this author
    • The first 2 authors contributed equally to this study.

    • Fax: (514) 227-5103

  • Georg C. Hutterer MD,

    1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
    2. Department of Urology, Graz Medical University, Graz, Austria
    Search for more papers by this author
    • The first 2 authors contributed equally to this study.

  • Quoc-Dien Trinh MD,

    1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
    2. Department of Urology, University of Montreal, Montreal, Quebec, Canada
    Search for more papers by this author
  • Claudio Jeldres MD,

    1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
    2. Department of Urology, University of Montreal, Montreal, Quebec, Canada
    Search for more papers by this author
  • Paul Perrotte MD,

    1. Department of Urology, University of Montreal, Montreal, Quebec, Canada
    Search for more papers by this author
  • Andrea Gallina MD,

    1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
    2. Department of Urology, Vita-Salute University San Raffaele, Milan, Italy
    Search for more papers by this author
  • Jacques Tostain MD,

    1. Department of Urology, St. Etienne University Hospital, St. Etienne, France
    Search for more papers by this author
  • Jean-Jacques Patard MD

    1. Department of Urology, Rennes University Hospital, Rennes, France
    Search for more papers by this author

Abstract

BACKGROUND.

C-reactive protein (CRP) represents a promising prognostic variable in patients with sporadic renal cell carcinoma (RCC). It was hypothesized that CRP can improve the prognostic ability of standard RCC-specific mortality (RCC-SM) predictors in patients treated with nephrectomy for all stages of RCC.

METHODS.

Radical nephrectomy was performed in 314 patients from 2 European centers. Life table, Kaplan-Meier, and Cox regression analyses addressed RCC-SM. Covariates included age, gender, TNM stage, tumor size, Fuhrman grade, and histologic subtype.

RESULTS.

The median survival of the cohort was 19.9 years. Age ranged from 10 to 77 years. Most patients were male (69%). T-stages were distributed as follows: T1-121 (38.7%), T2-45 (14.4%), T3-140 (44.7%), T4-7 (2.2%). CRP values ranged from 1.0 to 358.0 mg/L (mean 40.9, median 11.0 mg/L). In multivariable analyses, CRP was an independent predictor of RCC-SM (P = .003). The consideration of CRP in the multivariable model increased the predictive accuracy by 3.7% (P < .001). Moreover, the model with CRP performed 2.4% and 4.6% better than the UCLA Integrated Staging System (UISS) at, respectively, 2 and 5 years.

CONCLUSIONS.

CRP represents an informative predictor of RCC-SM. Its routine use could allow better risk stratification and risk-adjusted follow-up of RCC patients. Cancer 2007. © 2007 American Cancer Society.

Ancillary