The impact of preoperative serum C-reactive protein on the prognosis of patients with upper urinary tract urothelial carcinoma treated surgically
Version of Record online: 4 MAY 2007
Volume 100, Issue 2, pages 269–273, August 2007
How to Cite
Saito, K., Kawakami, S., Ohtsuka, Y., Fujii, Y., Masuda, H., Kumagai, J., Kobayashi, T., Kageyama, Y. and Kihara, K. (2007), The impact of preoperative serum C-reactive protein on the prognosis of patients with upper urinary tract urothelial carcinoma treated surgically. BJU International, 100: 269–273. doi: 10.1111/j.1464-410X.2007.06934.x
- Issue online: 4 MAY 2007
- Version of Record online: 4 MAY 2007
- Accepted for publication 9 February 2007
- C-reactive protein;
- upper urinary tract;
- urothelial carcinoma
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.
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.
This study indicated that an elevated preoperative CRP level predicts a poor survival in patients with UUT-UC.