Preoperative C-reactive protein in the Serum: a prognostic biomarker for upper urinary tract urothelial carcinoma treated with radical nephroureterectomy
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Preoperative C-reactive protein in the Serum: a prognostic biomarker for upper urinary tract urothelial carcinoma treated with radical nephroureterectomy. / Aziz, Atiqullah; Rink, Michael; Gakis, Georgios; Kluth, Luis A; Dechet, Christopher; Miller, Florian; Otto, Wolfgang; Gierth, Michael; Denzinger, Stefan; Schwentner, Christian; Stenzl, Arnulf; Fisch, Margit; Burger, Maximilian; Fritsche, Hans-Martin.
In: UROL INT, Vol. 93, No. 3, 01.01.2014, p. 352-360.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Preoperative C-reactive protein in the Serum: a prognostic biomarker for upper urinary tract urothelial carcinoma treated with radical nephroureterectomy
AU - Aziz, Atiqullah
AU - Rink, Michael
AU - Gakis, Georgios
AU - Kluth, Luis A
AU - Dechet, Christopher
AU - Miller, Florian
AU - Otto, Wolfgang
AU - Gierth, Michael
AU - Denzinger, Stefan
AU - Schwentner, Christian
AU - Stenzl, Arnulf
AU - Fisch, Margit
AU - Burger, Maximilian
AU - Fritsche, Hans-Martin
N1 - 2014 S. Karger AG, Basel.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - 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 multifocality, 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.
AB - 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 multifocality, 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.
U2 - 10.1159/000362248
DO - 10.1159/000362248
M3 - SCORING: Journal article
C2 - 25138778
VL - 93
SP - 352
EP - 360
JO - UROL INT
JF - UROL INT
SN - 0042-1138
IS - 3
ER -